Caregiver Stress: Some Solutions and Coping An excerpt from Into the Mist, When Someone You Love Has Alzheimer's Disease by Deborah Uetz and Dr. Anne Lindsay

There are certainly a multitude of variables that can cause stress for Alzheimer’s caregivers. It is physically, financially, emotionally, socially, and cognitively demanding. To cope with all of these stressors, you must recognize and address them. Letting them accumulate and fester will be damaging to you and your caregiving abilities. Below are methods of stress relief. Adapt them for your particular style, use as many as necessary to achieve stress-relief, and find methods of your own that work for you to relieve stress.

Try to avoid negative responses to stress. Some of the negative responses that are common among Western societies include alcohol and other substance abuse, overeating and eating food that is comforting but not particularly nutritious, and shopping or impulse buying to the extent that it can affect your financial well-being. Most of these provide only temporary stress relief and, if overused, can add to your stress by adding unnecessary physical and financial stress.

You have likely learned during the course of your lifetime what stress relievers work best for you. To be effective, individualize your stress relief to meet your needs and personality. Some effective stress-relieving techniques include:

Knowing your limitations. This has been discussed in some detail previously. Know when you have reached your limits regarding stress – failure to do so will hurt you and could lead to abusive behaviors when you are dealing with your affected loved one.

Plan ahead. You know that stressors will arise and often can anticipate what the stress will be. When it comes to caregiving, this means planning ahead for how to deal with financial issues, the physical demands of caregiving, for the cognitive challenges you may face, and for the emotional strain. As in all of life, some things can’t be predicted. You can, however, plan how you will deal with stress as it arises by learning and using stress relief techniques and making them a part of your life to the degree that it will be almost second nature to rely on them when you most need them.

Uncertainty about the future can cause significant anxiety and stress. There will always be uncertainty about the future, whether there is a person in the family who has Alzheimer’s disease or not. To cope with uncertainty, continue to do what you are currently doing: educate yourself about Alzheimer’s disease and, to the extent possible, prepare yourself for what is to come. It is always different when it is your loved one involved and there will likely be events for which you haven’t prepared yourself, but the more you can prepare yourself for the future the better. Note that preparing yourself is vastly different from worrying about the future and stewing about it. The latter is stress inducing and counter-productive. There is a great deal of power in the thoughts contained in the Serenity prayer used by Alcoholic Anonymous and other groups – paraphrased, it advises us to do our best to control the things that we can control, let go of the things that we cannot control, and the wisdom to know the difference between the two.

Maintain a healthy diet. Eating “comfort food” now and then is fine, but the more that you can eat a healthy, balanced diet the better it is for your overall health and ability to cope with stress. Foods and substances high in the following substances tend to compound the effects of stress by stimulating the same chemical substances and bodily functions as stress itself: caffeine, sugar, nicotine, alcohol, and sodium (salt). Exercise. For many people exercise is one of the most effective means of relieving stress and maintaining good emotional health. Research has shown that brain chemistry changes in ways that improve your sense of well-being and overall mental health. It is one of the few things that we do in life that is good for almost every aspect of your health, both mental and physical. Caregiving also tends to lead to a tendency to isolate oneself, and finding ways to exercise outside of the house, even by taking walks with a friend, is an excellent way to avoid isolation that can lead to and intensify depression and other effects of stress. Yoga is an excellent formalized exercise routine when it comes to maintaining health and reliving stress.

Work on your attitude. Negative thinking is destructive and serves no purpose other than to make you feel worse about your situation and the world around you. As discussed before, you must be realistic about your ability to undertake caregiving. If you think negatively about the situation you now find yourself in without honest appraisal of the situation, you’re not being honest with yourself or realistic. If your realistic appraisal tells you that some or all of the tasks of caregiving are beyond your capabilities, then give yourself credit for being honest with yourself and work from that premise. If you simply tend to work from an “I can’t” perspective, learn to challenge your negative thought patterns. Catch your pattern at its beginning and counteract you negative thoughts with more positive ones. If it helps, write both down. If you tend toward the negative, you may have to work to find more positive thoughts to counterbalance the negative ones. The positives are there but some people have to work harder to find them. Use positive self-talk if it helps: tell yourself that you can do things rather than you can’t, that you are capable, and so on. And do not dwell on your failures. You will have them – everyone does. If you dwell on them they will magnify, overshadow your successes, and lead to negative thinking patterns. Do not avoid your emotions. You are in a situation in which strong emotions will sometimes arise and you must acknowledge and deal with them. Denying their existence will lead to those emotions coming out in other ways and a tendency to feel more easily overwhelmed. The emotions that you have denied and suppressed are underlying the stress that piles on top of them, leading to an additive effect that can feel suffocating after a while.

Engage in leisure and recreational activities. You need to find a balance in your life and leisure/recreation should be a part of that balance. If you allow your entire life to be consumed by caregiving, it will show in your stress level and your caregiving abilities.

Avail yourself of respite care, adult dare care services, and other services that are available in your community. More is covered on this topic in a separate section detailing care options. Take the breaks offered by these services and find ways to do things that bring you pleasure and some stress relief during these breaks.

Don’t forget to laugh. Despite all of the stressors in the life of a caregiver, humor and laughter must remain a part of your life and part of the life of the person with Alzheimer’s disease.

Use established stress management techniques and/or healthy ones that have a history of being an effective means of stress relief for you. Techniques including deep breathing and breathing control, progressive muscle relaxation, guided imagery, and stress inoculation are just some of the methods currently in use. You can learn these techniques in one or two sessions with a professional, videotapes are available to teach the techniques, and there are books on the market that also teach the techniques. Although it may be harder to learn any of these techniques properly through books, if that is your only alternative it is better than not using any method at all to relieve stress.

We have alluded occasionally to your caregiving abilities deteriorating if you do not deal with your stress level, as well as to learning what your warning signs are for all sorts of situations, including stress overload. If you find that you are showing a number of these signs, it is time to reevaluate your situation, get assistance for yourself, get assistance with caregiving, and actively address your stress level. If you are showing signs of burnout, which may include acting in abusive ways toward the individual with Alzheimer’s disease, it is time to consider alternatives to you being the primary caregiver. Here are some of the signs of stress overload and burnout:

New physical problems or exacerbations of old ones such as high blood pressure, digestive problems, sleep difficulties, headaches, muscle tension leading to discomfort and other problems, and so on. Any of these are signs that you need to find ways to decrease the ways in which stress is affecting you.

Feeling chronically mentally and physically exhausted.

Chronic anger, depression, worry, anxiety, or irritability. Become easily angered with the individual who has Alzheimer’s is a sure sign that you are approaching burnout and need assistance or need to take a complete break from caregiving.

Significant and chronic changes in your sleep patterns.

Increasingly isolating yourself and your loved one.

Acting out toward the person with Alzheimer’s disease. This may include withholding care, intense anger at the individual who has put you in your current position, actively or passively withholding seeking medical attention when it is needed, and physically striking the person. If you have experienced this degree of stress, you have reached burnout and it is time to take a break from caregiving and consider alternate arrangements for your loved one.

If you have reached your limit and have to consider alternate caregiving arrangements for your loved one, do not consider it a failure. To the contrary, you should congratulate yourself for your honest appraisal of the situation and your ability to do what you need to in order to obtain the best care for the person you love.

Deborah Uetz B.S. Education Author of Into the Mist, frequent radio guest including the Dave Glover Show, Healthy Wealthy and Wise, and Jacqueline Marcell's radio program Coping With Care Giving. *Into the Mist is available online at Amazon, Borders, Barnes and Noble or at my website listed below.

Into the Mist, When Someone You Love Has Alzheimer's Disease http://www.intothemist.us

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