The numbers related to caregivers are absolutely astounding. According to a 2009 survey conducted by the National Alliance for Caregiving, 31% of American households have at least one someone caring for someone else. Some of those being cared for are children with special needs, but an increasing number are patients with dementia-Alzheimer's disease who are over 60. Many of the caregivers are seniors themselves.
There's a hard fact related to providing care for seniors. While our intentions may be reasonable, even honorable, there are few of us who are prepared by temperament, training, strength and/or experience to do that job, in particular over a long span of time. It's not at all like caring for an infant or child. However, there may be a way to help handle the caregiving challenge that's as nearby as a good friend or a close relative. Why do it?
A Caregiving Lesson
Have you ever flown on a commercial aircraft? Remember what the flight attendant said at the beginning? Along with seat belt and escape hatch demonstrations, there was instruction regarding the oxygen mask that drops down when there's a rapid change in cabin pressure. The lesson went something like this: "Put your mask on first and then attend to children and others seated near you." Take care of yourself first? Yes, that's what in-flight caregivers are expected to do, for everyone's best interest.
It makes good sense for caregivers at home, as well. That's especially so when considering that the "flight" for home-based caregivers is often for an undetermined distance in time and energy. Their destination may be a long way off.
Informal Caregivers Contract
There are issues regarding dementia-Alzheimer's that can be particularly draining on the energy, spirit, and health of a caregiver. It can also strain relationships. Changes in a loved one's eating, sleeping, communication, and/or continence can be difficult to bear. Wandering, hallucinations, delusions, and repeating the same questions and information over and over, can wear down the caregiver's ability to focus and provide effectively for even essential needs.
So, early on, when first accepting the challenge of giving care, also consider accepting the challenge to receive some care yourself. That is, decide who among your network of support might be best for agreeing to monitor you and your ability to carry on day-to-day. A written Caregivers Partnership Agreement could have five parts.
- Getting Out of Yourself. Agree that you will let this special person in your life tell you when he or she sees that you may need relief, a time of respite and rejuvenation. What that means is stepping away to clear your head and recharge your batteries. Have lunch or dinner at a restaurant. Go to the library or a shopping mall. Visit a friend. Whatever it takes, accept that those islands in time and distance away from giving care can actually make your caregiving better.
- Touching Someone's Ear. Agree that you'll make regular telephone connection to someone in your support network, if for no other reason than to have contact with a person outside your home. Caution: Complaining might be inappropriate and unproductive, but reflecting what's been happening and how you're coping with it could be healthy for you. Being open to suggestions is healthy, too.
- Engaging Mutual Support. In many communities, through senior centers and churches, for instance, there are support groups that meet regularly with the needs of caregivers in mind. Being with others in your situation is a reminder that you're not the only one in the world facing the challenges of caregiving. Shared comfort, compassion and suggestions can be illuminating, uplifting and helpful. Agree, early in your caregiving journey, to take advantage of support group support.
- Accepting Brief Relief. Going outside your home to take a break, attend a meeting or go to church will usually require someone else to be the substitute caregiver. Many community agencies and health plans provide for this sort of break. It could also come from a friend or relative. Implied is the attitude that, yes, another person can do the job for awhile besides you. Believe it and welcome the relief.
- Keeping Consistently Healthy. The mental and physical toll on people who give care can be immense. Agree to see your family doctor on a regular basis. "Regular" may be just an annual checkup, but part of your agreement should include accepting someone else's impression that you might benefit from a visit to the doctor. Depression, for example, in people giving long-term care isn't usually recognized until too late. The signs are plentiful and can reflect more than routine weariness. Denial, anger, social withdrawal, anxiety, sleeplessness, irritability, lack of concentration and physical problems when left unattended can severely hinder your ability to attend to the person you're caring for.
Customizing a Caregiver's Agreement
Your Partnership Agreement for Giving Care to a Caregiver can include whatever you want. It can be adjusted or expanded at any time. However, the importance of having an agreement is underscored by reality. Giving care at home an be a lonely and draining pursuit. Care for yourself first, and be deliberate about identifying who your partner will be. This is important, so don't be shy. And, discard the notion that it will be an imposition. Now, who else do you know who would benefit from a caregiver's agreement?
Further Reading:
Mayo Clinic. " Caregiver Depression: Prevention Counts " (accessed January 11, 2011).
Gather, Peter. "Respite Care Spells Relief for Stressed Out Caregivers." Caregiver.com (accessed January 11, 2010).
Womack, Dorothy. "Caregiver Guilt." Caregiver.com (accessed January 11, 2010).
More Information About Caregiving:
Alzheimer's Disease Education and Referral (ADEAR) Center
Alzheimer's Foundation of America
National Family Caregivers Association
