We are excited to feature a wonderful blog by Dr. Diana Denholm. Diana B. Denholm, PhD, LMHC, has been a board-certified psychotherapist for more than 30 years. For 11 years, she was the primary caregiver to her husband during a series of grave illnesses. More detailed guidance, support, and resources are in her new book, The Caregiving Wife’s Handbook: Caring for Your Seriously Ill Husband, Caring for Yourself (Hunter House, December 2011, www.caregivingwife.com).
Stress-Busting Tips for the Family Caregiver
Family Caregiving is serious business, and caregiver stress is a serious problem. Caregiving can destroy people and relationships, yet a far more positive outcome is possible. Using the right tools, both we and those we care for can make it through the challenges, including a death, emotionally whole and with compassion for ourselves and for each other.
I know because I’ve been there. For over 11 years, I was the primary caregiver for my husband, who was gravely ill the entire time. Drawing both from my own experience and those of numerous caregivers I have counseled in my private practice, here are some basic strategies to help you avoid burnout in your caregiving role.
Establish expectations. First and foremost, get on the same page as the ill person in terms of expectations for everyone involved in their care. If you are the primary caregiver, discuss and agree on what you’ll expect of each other and what you are willing to do and not do. Topics can include the type of care and who will perform it, legal and financial matters, household management, visitors, sleep, and sex and intimacy, among others.
Use basic communication tools. In my book, I show how to raise issues, have problem-solving discussions with the ill person, and create useful Understandings. Once these Understandings are created, household battles and stress will greatly diminish, leaving a more peaceful and happier environment in its place. Communicating carefully, thoughtfully, and skillfully with the ill person is the single-most helpful practice you can learn and use.
Avoid enabling. A common mistake caregivers make is thinking that everything is their responsibility. This allows you no spare time and will keep you from caring for yourself. To avoid this trap, work together, rather than enabling or controlling the ill person. Don’t do for the cared ones what they really can and should do for themselves. Enabling creates invalids. Don’t micromanage what they are able to do, even though it may be far from perfect. The less you enable, manage, or control, the more time you’ll have for yourself and the less stress you will experience. When appropriate, be glad to say, “It’s not my job,” even though others might think otherwise.
Give yourself permission for self-care. Where do you find the time and energy to eat right, get plenty of sleep, exercise, stay connected with friends, and stay spiritually involved? You can manufacture free time by letting the ill person do more for him or herself. And once you have that time, give yourself permission to take some time away from caregiving. It’s okay to have fun, even if your loved one is suffering. Start small. Give yourself permission to enjoy one simple thing, whether it’s a short walk in the fresh air or sitting in the bathroom meditating. As you become comfortable with small steps, branch out to other self-care activities.
Stop energy drains. Our inner dialogue helps us survive, because it allows us to let off small bursts of steam and keeps us from screaming things out loud or acting on them. But too much pent-up anger or too many disturbing thoughts not only create negative outcomes, they also steal our energy. There are healthy ways to release anger. Simply write down, for your eyes only, all the things you’d really like to say but won’t, just to get them out of your system.
Keep up friendships and normal activities. Find at least one confidant. Create ways to have enjoyment given your finances and freedom, whether that’s meeting a friend in a park or taking a respite vacation. Take real or inner vacations to get in touch with people and reclaim your sense of self. Do something where you can feel your life is in your own hands, something that is outside of your caregiving role, whether that’s joining the choir, a bowling league, or volunteering. Have at least one activity that lets you know something in your life is normal and enjoyable.
While it seems that caring for your ill family member is your biggest responsibility, in truth, taking care of yourself is number one. A broken caregiver can no longer be of service. Be gentle and forgiving with yourself.
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