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Caregiver stress and depression hits close to home

by Carol Bradley Bursack, Editor-in-Chief

While caregivers have an abundance of specific questions about their care receiver's needs, a recent survey by Eldercarelink.com suggests that caregiver depression and caregiver stress are the most requested topics - and why not? Caregiving can isolate us from society at large. It can bring on guilt, generally undeserved, over not being able to do our caregiving job to perfection. It can bring on our own health problems. Of course people want to read about caregiver depression and stress - that's one way of knowing we aren't alone. And knowing we are not alone is one way to lighten depression and stress.

As a family caregiver who willingly cared for a number of elders, I had moments of depression, and many, many moments of stress. I had times when I wondered, "How long can I do this?" I had times when I wondered if I was up to the job at all. This is human. How do we handle caregiver depression and stress? When do we seek help and if we do, what kind?

The first step is to evaluate how bad it is

Let's start with the worst case scenario in case you need to get yourself to a doctor right away. Are you thinking of harming yourself or your care receiver? Do you neglect your own health to the point that you have put on an alarming amount of weight, or conversely, lost far too much? Are you on the brink of "losing it," to the point that you could abuse or neglect your care receiver?

If this is the case, please see a doctor. Family health clinics will generally see people who cannot afford a regular medical visit. Please don't put off seeking medical help if you are depressed enough to consider suicide or abuse. Call your local hotline. In many states, you can call 2-1-1 for help. Call 9-1-1 if you are really having an emergency. Get help.

Most of us fall into the "how long" category

Living in the moment has always been a challenge for me. I'm not sure if it's genetic or a learned response, but I do remember my mother talking about "next Christmas" as we were putting away the last of the Christmas decorations from the holiday that had just passed. A few times I did think, "Aren't we getting a little ahead of ourselves?"

What does this have to do with caregiving? I remember more than one time, during more than one long caregiving episode, when I would just - privately - collapse, thinking, "I don't know how long I can keep this up." Sometimes, I'd cry. That generally relived stress a little. Often, I'd pray. I felt that I was doing what was needed, and what I was cut out to do. But I would get overwhelmed by the sheer enormity of the task.

Because I was the person in the same community as my elders, and I happened to have a childless aunt and uncle, whom I loved dearly, but they did add to my share of elders needing care, my caregiving years extended into two decades. Often, I was the primary caregiver for multiple elders, plus two children, one of whom had chronic health problems.

Yes, I have a wonderful sister who would drive 80 miles round trip nearly every weekend to see our parents. Her help was invaluable. But when it came to the day-to-day stress of wondering what condition each elder was in, and whether or not there would be an emergency to which I would need to respond, well, it was pretty much up to me.

Since most of my elders had long, drawn out illnesses - the slow declines that are agonizing for the elder as well as the caregiver - I would, at times, simply give into feeling completely overwhelmed.

How did I cope personally?

I'm not a particularly social person, but I did know the value of sharing my caregiving life with people who understood what caregiving is about. That's why I wrote my book, Minding Our Elders. Writing down my own caregiving stories, plus making myself get out and interview other caregivers gave me perspective. I found the magic solution, if one can call it that, of sharing the "load." When we talk with people who know what we are going through, most of us experience reduced stress levels.

Alzheimer's organizations provide needed assistance in human form

Thinking back on this made me grateful for some leaps forward for caregiver stress reduction. The blog post, Alzheimer's Association and Alzheimer's Foundation of America Offer Unique Help provides information about caregiver support groups. These Alzheimer's focused organizations can give you information, advice, and perhaps most importantly, human contact with people who know what you are going through. Please read the article and post the information on your refrigerator or near your computer. Even if you don't need it now, you or a fellow caregiver may want to contact one of these organizations after you've helped your loved one through an emergency, or at any other time you feel overwhelmed. Sometimes, just a kind voice on the phone is enough to help alleviate stress levels.

Eldercarelink.com articles that focus on stress

Two articles on Eldercarelink.com are specifically targeted toward caregivers (all of us?) who feel stressed or trapped from time to time. These articles focus on ways to get you out of the house for breaks or to get respite care. Read Caregiver Stress Can Make Carers Feel Trapped: What to Do? and Depression in Caregivers: Most Caregivers Need a Way to Refresh Their Reserves for information and stress reduction.

Practical tips for stress reduction

  • As mentioned near the beginning of this article, if you are in serious stress, please see your doctor.
  • Breathe. Yes, breathe. Ever had a doctor tell you to "breathe normally?" Yes, that's pretty routine during a checkup. If you are like me, you may have to think about it. What is breathing normally? When I am stressed, I can catch myself shortchanging the in-breaths. I'm not exactly holding my breath, but I'm breathing shallowly. So, breathe deeply. Set a timer if you must. Then practice feeling what it's like to breathe like a relaxed person should breathe. You may surprise yourself.
  • Stretch. Way back in the 1970s, before yoga was "cool," I was doing yoga in a lame attempt to prevent my debilitating migraines. Yoga didn't help the migraines, but as I aged, and returned to my rather sloppy but for me effective routine, I found that it has helped with arthritis pain and stress reduction. The trick is that I have to do it. Thinking about getting down on the floor and doing the stretches (and breathing as I do so) doesn't work. But actually doing the "work" of stretching is effective. Find a DVD at the library on yoga or stretching and see what that does for you (check with your doctor if you have any health issues at all).
  • Shrug your shoulders. Do you carry the world on your shoulders? You can tell if they practically touch your ears. That's stress. Tack notes around the house that remind you to shrug your shoulders. It sounds silly, but it helps.
  • Dance. Do you like music? It's a bonus if your care receiver does too! I remember one of the fantastic Certified Nursing Assistants (CNAs) at the nursing home where my parents lived their last years. She would grab Dad, using a "gait belt" so he couldn't fall, and get silly and dance with him. I kept CDs Dad liked, generally of big band music, in his room, and when he was in the mood, they literally had a ball! But you can dance by yourself. That can feel really good and it's great exercise.
  • Make a pact with a caregiving friend. You can "unload" on each other. The rules? You aren't trying to "fix" each other or your problems. You just need someone to listen. Listen to each other. Hug if you are physically in the same room. Mainly though, let each other vent. That can be invaluable.
  • Cry. Yes, cry. Crying can really help.
  • Pray. If you are so inclined, pray. Surrender your helpless, overwhelmed feelings to a power greater than yourself, whatever your belief. This is one form of stress reduction that helps many.

However, you still will probably need to take some practical steps to get some time to yourself. Go to your state's Web site and type "aging" into the search engine. Find the National Family Caregiver Support Program. Ask these folks for help.

Hire some in-home agency help. Get your elder to adult day care. Look into assisted living for your loved one if you have had all you can take. Getting help is not a sign of weakness. It's a sign of strength. You'll still be a caregiver. You just won't be alone.