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Caregiver Series: Calling all Caregivers: Take Your Oxygen First!

POSTED BY: Florida Hospital

How to Guard Your Health to Protect your Loved One

Yes, caregivers we are talking to YOU! The selflessness it takes to care for a loved one, week after week, can exact a toll. Living a life of long-term stress is a well-studied consequence of caregiving for a loved one with a chronic illness. But how often are you asked, and how are YOU doing?  “It’s common for caregivers to prioritize the needs of their loved ones,” said Rosemary D. Laird, MD, MHSA, Geriatrician with the Florida Hospital Medical Group.

During the month of November, now known as National Family Caregivers month, Dr. Laird wants to make sure caregivers understand that when a caregiver sets aside their own needs amid recurring and chronic stress over their loved one’s health, emotional and physical problems for the caregiver are much more likely.

“It’s critical for caregivers to set aside time to attend to their own medical, spiritual and social needs,” said Dr. Laird. Just as you wouldn’t drive without a seatbelt, you shouldn’t care for someone else without taking steps to ensure you are around to help them and at your best.

To get her point across, Dr. Laird helped to popularize an analogy to teach caregivers the importance of caring for themselves. She co-authored a book called “Take Your Oxygen First: Protecting Your Health and Happiness While Caring for a Loved One with Memory Loss.” The book, co-authored with TV host Leeza Gibbons and psychologist James Huysman, centers on the caregiving challenges faced by Gibbons and her family as they cared for her mother, who had Alzheimer’s disease. The title of the book is perhaps its most important lesson and references the instructions given by airline flight attendants. If passengers don’t put their own oxygen masks on first, they may have only seconds before becoming disoriented — and unable to help anyone else.

Dr. Laird knows putting your own needs first is not easy. After all, caregivers by their very natures are used to putting their loved ones first. “I’ve had caregivers tell me they’d postponed their own mammograms, switched appointments with their loved ones or filled a loved one’s prescription before their own when money was tight,” Dr. Laird said. “But a caregiver who ignores the effect of long-term stress on their health will ultimately become unable to effectively care for their loved one. Taking your own oxygen first is ultimately as much about your loved one’s health as your own.”

Here are some tips from the AARP to limit your chronic stress:

  • Eat right. Also, take a daily multivitamin and drink six to eight glasses of water a day.
  • Exercise daily. Even if it’s only 15 minutes of yoga or walking, move your body each day.
  • Get outdoors. Fresh air renews, even on a brief outing.
  • Get your zzz's. Aim for seven to eight hours of sleep. When your loved one naps, you can nap, too.
  • Treat yourself. Don’t ignore your own aches and pains until they turn into something serious.

 

Good Stress and Bad Stress

Stress isn’t always a bad thing. If it’s relatively brief, it can help us rise to a challenge. It can be stressful to drive through a crowded city, but that stress helps you focus on the task at hand. Our body has hormones and chemical reactions to keep our minds and bodies focused and high functioning. And the body returns to normal after you’re done.

But what if the body is never given a chance to recover? Continually exposing your body to stress hormones can break down its defenses.

Enter caregiving. Research shows those who have been providing care for five years are 70 percent more likely to say their own health has worsened.

Though each caregiving story is unique and entails some stress, some situations are more burdensome than others. Most caregivers help their loved one with at least one routine activity that some of us take for granted, like eating, using the toilet and bathing. According to the 2015 AARP publication, “Caregiving in the U.S.,” caregivers report the most difficulty with dealing with incontinence or diapers, using the toilet and bathing.

Traditional gender roles often play out in caregiving, as women are more likely to help with grooming and bathing. Overall, female caregivers are 40 percent more likely to feel high stress.
Caring for a spouse or parent is often more stressful than caring for a more distant relative or a non-relative. Finally, caring for those with a memory loss disorder such as Alzheimer’s disease can be particularly taxing on a caregiver. About one in five caregivers report their loved one has a form of dementia.

Half of these caregivers say they experience a lot of emotional stress. They tend to help their loved one with more routine daily tasks and are more likely to say their own health has suffered.
At some point in their caregiving, almost 60 percent of caregivers are diagnosed with depression. Caregivers can become more anxious and develop sleep disorders.

The AARP report found several other groups of caregivers who are especially vulnerable to the stress of their work. They are:

  • Older caregivers
  • Caregivers who didn’t have a choice to take on their role
  • Caregivers who provide the most care (more than 21 hours per week)
  • Caregivers dealing with complex care situations

Just as a schoolteacher who spends his days around sniffly children would take precautions to avoid catching a germ, falling into one or more of these categories should be a special warning. “Take Your Oxygen First” has extra advice for the more than 10 million Americans who are “sandwiched” between caring for their loved one and their children.

 

The ‘Sandwich Generation’

According to “Take Your Oxygen First,” the typical member of the Sandwich Generation is “a 48-year-old woman with a steady job who spends about 20 hours a week caring for her parents.” These caregivers “find themselves pushed and pulled from two directions as they give care to their memory impaired loved one while also looking after the needs of their children.”
Some of them are also finding a silver lining as their children help with the dressing, feeding and transportation of parents. Most of those who feel they are succeeding attribute their success in part to the help from younger members of their family, the authors report.

Here’s how members of the Sandwich Generation can take their own oxygen first:

  • Accept offers of help
  • Have a backup plan to care for both your children and parents
  • Help your children understand their grandparents’ illness
  • Keep your physical, emotional and spiritual health in top shape

 

Seniors as Caregivers

Many senior caregivers rank their own health and quality of life as poor, even if the person in their care moves to a facility or passes on. Once more, the mortality rate for elderly caregivers is higher than for non-caregiving seniors of the same age.

This is because seniors face unique pressures as caregivers. For some, the transition to being a caregiver is a natural and easy one. For others, it is more difficult. Feelings of loss and sadness can surface, or perhaps anger and resentment, as the illness robs the caregiver and loved one of their golden years together.

Often, it is helpful to find a support group with other senior caregivers facing similar challenges. The Alzheimer’s Association has numerous resources available in most areas for caregiver training and support.

Other tips for senior caregivers:

  • Keep your physical, emotional and spiritual health in top shape to “take your oxygen first.” And don’t put off your own preventive and regular medical care.
  • Become knowledgeable about resources for respite in your community. Schedule a regular day for rest each week and one week per year at a minimum. Consider asking your children or allowing other friends or family to help provide you this needed break.
  • Have a backup plan for caregiving set in advance so if you become ill and need medical testing or hospitalization you will have back up ready to go.
  • Be accepting of offers to help.
  • Consider in-home personal response devices for emergencies. This could be a valuable part of allowing you and your loved one to age in place, independently and safely.
  • Consider getting a medical alert bracelet identifying you as a caregiver of someone with memory loss, and naming another family member who is aware of your loved one’s needs, as contacts in case of an emergency.

 

Men as caregivers

About 40 percent of caregivers are men, though some don’t have the skillset required, including cooking, cleaning and personal care. Men also may be socialized against asking for help and to suppress their feelings.

Dr. Laird has some advice:

  • Get help when your loved one needs help in the bathroom. This can be a good place to begin using a paid caregiver.
  • Schedule a regular day of respite each week and one week per year, at a minimum.
  • Consider in-home personal response units to summon emergency personnel.

Dr. Laird, a board-certified geriatrician, has more than 20 years of experience helping patients and families navigate the joys and challenges of life’s later stages. She was named the American Geriatrics Society “2013 Geriatrician of the Year.”

Her team at Centre for Senior Health in Winter Park is focused on getting to know both their patients and the caregivers so critical to their quality of life.

For more information about Dr. Laird’s Winter Park practice, call (855) 303-DOCS. Click here to read more from Dr. Laird's Caregiver Series.