Organizations around the US, including Family Caregiver Alliance in the Bay Area (caregiver.org), teach a course called “Powerful Tools for Caregivers,” developed by an organization in Portland. You can read general info about the self-care education program for family caregivers at powerfultoolsforcaregivers.org
As part of the course, class participants receive a copy of a book titled “The Caregiver Helpbook.” The book is available in both English and Spanish. Brain Support Network volunteer Denise Dagan is reading the booklet and will be sharing the highlights, chapter by chapter.
The title of chapter two is “Reducing Personal Stress.” Obviously this chapter explores the stress of caregiving. As the book states: “Studies show that a certain amount of stress is helpful. It can challenge us to change and motivate us to do things we might not do otherwise. However, when the amount of stress overwhelms our ability to cope with it, we feel ‘distress’ or ‘burnout.'”
“A basic premise of this chapter is that each of us has a reservoir of strength. The challenge is to identify our strengths and build on them. … The philosophy of Virginia Satir, noted family therapist,…reminds us that how we perceive and respond to an event is a significant factor in how we adjust and cope with it.”
This chapter contains lots of useful worksheets. You’ll need to purchase the book ($30) to obtain the worksheets.
Here’s Denise’s report on chapter two.
Robin
The Caregiver Helpbook
Chapter Two – Reducing Personal Stress
Factors that Affect Stress:
* Whether your caregiving is voluntary or not. “If you ‘inherited’ the job and feel you had no choice, the chances are greater for experiencing strain, distress, and resentment.”
* Your relationship with the care receiver. “If the care receiver has always been demanding and controlling, you will probably feel more stress, anger, and resentment. Sometimes people are caregiving with the hope of healing a relationship. The healing may or may not happen. If healing doesn’t happen, the caregiver may feel regret, depressed, and discouraged. A professional counselor, spiritual advisor, or trusted friend can help deal with such feelings and emotions.”
* Your coping abilities. “How you have coped with stress in the past predicts how you will cope now. Identify your current coping strengths and build on them. Learning new coping skills also will help make your caregiving situation less stressful.”
* Your caregiving situation. “Does it require 24-hour-a-day availability, or just the occasional phone call?
* Whether support is available. “Caregivers who feel isolated and without adequate support usually experience a higher level of stress.”
Steps to Maintain Health and Avoid Distress:
Step 1. Recognize your warning signs of stress. “It’s important to recognize stress early and do something about it, before it causes you serious problems.” The warning signs are different for each person. They can be physical, like insomnia, or fatigue, or they may be “voiced in the words of others: ‘You look so tired,’…’Why are you snapping at me?’”
Step 2. Identify your sources of stress. Examples are, demands on your time, energy, or money; conflicting responsibilities; difficulty meeting your caree’s needs; feeling trapped or isolated; family discord; unrealistic demands and expectations, etc.
Step 3. Identify what you can and cannot change. “The only person you can change is yourself. You may be able to change a situation, how you respond to it, or your perception of it, but you can’t change another person.”
Use these “guidelines to look at your situation and to determine what can and cannot be changed:”
– Accept the reality of your caregiving situation. “…adapt to ongoing changes and losses caused by the care receiver’s illness. These changes cause you to redefine your life. What was normal has changed. You are living with a new reality.”
– Educate yourself about the care receiver’s disease. “You will be better able to identify what you can and cannot change when you understand the disease.”
– Identify unrealistic expectations, especially your own. “If you have unrealistic expectations of yourself (like, ‘I can do everything myself.’), your expectations of what can be changed probably will be unrealistic also.”
– Seek and accept support. “Often you can make changes only with the help of others. Seeking and accepting support may be the single most important factor in making constructive changes.”
– Identify what you still have, rather than focus on what is lost. With some modifications you may still be able to achieve some life goals, like travel (shorter trips or with a third person to help). “Many caregivers, as they learn more about themselves, experience personal growth. That is the ‘gift’ that can often be found in difficult times.”
– Let go of what cannot be changed. “Accepting the situation as it is…releases new energy for…seeing new possibilities.”
Step 4. Take action to manage your stress. “There are many different tools for managing stress. But you must find what is most effective for you.”
Proven ways to manage stress include:
> Managing your thoughts, beliefs, and perceptions. “As a caregiver there may be times when the only thing you can change is how you view a situation. There are several tools for managing thoughts, beliefs, and perceptions. Two that can be helpful are:”
* Reframing is learning to look at things in a different (more positive) way. There’s a worksheet for this on page 35. “For example, a caregiver who is angry at her brother for helping only once a month versus taking the view that ‘any help, no matter how little, will lighten my load.’” Reframing can make you feel less burdened and more in control.
“Changing your perception from a caregiver to care manager is a way of reframing. As a care manager you assume an active role and reach beyond giving hands-on care, to planning and coordinating care and using available resources.”
* Self-talk is what we say to ourselves. “Negative self talk (I can’t, I should have, Nothing I cook is ever good enough for mother.) can lead to depression.” Positive statements counteract the effects of negative thinking. “This helps to change one’s attitude, promote relaxation, and reduce stress.” Instead, tell yourself, “I am preparing nutritious food. I am doing my best. That is good enough.”
With determination, patience, and practice, you can change your self-talk from negative to positive.” Follow these steps:
– Identify your negative thoughts.
– Write your negative thoughts to identify and clarify them.
– Challenge your negative thoughts. Give them a good argument. They probably won’t hold up as reasonable or logical.
– Write a simple, positive statement for each thought you want to change.
– Memorize and repeat the chosen statements to establish the habit of positive self talk.
– Put your written statements where you see them frequently, as a visual reminder.
> Practicing self-care means that you:
* Learn and use stress reduction techniques.
* Attend to your own health care needs,
* Get proper rest and nutrition.
* Exercise regularly.
* Take time off without feeling guilty.
* Participate in pleasant, nurturing activities
* Acknowledge and take satisfaction in the things you do well, and Reward yourself on a regular basis.
* Seek and accept the support of others.
* Seek supportive counseling when you need to, or talk with a trusted counselor, religious advisor, or friend.
* Identify and acknowledge your feelings. Don’t rely on drugs, alcohol, cigarettes, or tranquilizers.
* Tell others what you need. Don’t assume “they should know.”
* Change the negative ways you view situations.
* Set goals and prioritize.
> Getting social support. “Support from family, friends, and others is an important stress buffer.” Consider a support group.
> Using techniques that lower stress. “It’s little help to identify your stressors if you don’t take action early to reduce them. Recognize obstacles to your taking action.” These quick and easy stress-busting techniques can fit into your busy life:
* Employ basic wellness practices; proper diet, adequate sleep, regular exercise.
* Breathing for relaxation; Close your eyes. Focus on your breathing. Inhale to the count of seven, slowly and deeply. Exhale to the count of seven, as you let go of stress. Repeat for one or two minutes (or longer).
* Meditation aids in relaxation and in achieving physical and mental well-being. There is a meditation instruction on page 33. Many hospitals and clinics have mindfulness-based stress reduction classes. Many are even free!
* Music is often used specifically for healing and decreasing stress and tension. “Music can be healing for both you and your care receiver, either together or alone. People with dementia, especially, respond to music when they may respond to little else.” Use these steps as a guideline:
1. Choose soothing music you like.
2. Relax and close your eyes.
3. Breathe deeply and easily.
4. Lose yourself int he music, listening with your body, not your mind.
5. After the music is finished, open your eyes and notice how you feel.
* Humor. “Tears and laughter are closely related. They each offer a release of tension and are often intermingled. Humor does not minimize the seriousness of a situation; rather, it helps you embrace it.” Read the comics, watch a funny TV show.
> Developing plans of action. Use those tools from chapter one!
> Finding hope and meaning. “It is a way to make sense of our circumstances. … A search for meaning can be a conscious choice. There are many ways to stimulate your search.”
– Ask yourself questions like, “What am I to learn from this?”
– Reflect on your experience, especially after a difficult time.
– Talk with a trusted person to help clarify your thoughts and feelings. As you tell your story, it often takes on meaning.
– Writing is another way to clarify your thoughts and feelings, like talking to yourself. Reread your journal periodically.
– Seek spiritual renewal
– Denise