Pat has been caring for her husband Jack for seven years since a car accident left him paralyzed. When Pat looks in the mirror, she sees a woman who looks much older than her 37 years and is frustrated that she never has time to spend on herself.

Greg suffers with arthritis in his hands. His partner Bill struggles with Parkinson’s disease and needs Greg’s help with most activities. As the level of pain increases in Greg’s hands, so does his anger with Bill each time he needs to stop what he is doing to help.

June’s mother lives down the street and has relied on her for help since her father died three years ago. June’s husband and children also rely on her to keep their household running smoothly. Lately, June finds it difficult to remain upbeat and goes back to bed after the kids leave for school.

Franco and Lydia have been married 55 years. After Lydia was diagnosed with inoperable cancer, they agreed she would remain at home until her death. Franco has worked tirelessly making sure Lydia remains comfortable yet he has been battling the same cold for four months and refuses to take time away from Lydia to go to his doctor.

Caregivers that place their own physical and emotional needs after their care responsibilities often find themselves feeling frustrated, angry, depressed, or physically ill. Like the caregivers in the scenarios above, many cope with the competing demands in their lives at the expense of maintaining their own health and well-being. This publication offers coping strategies for caregivers based on identifying, changing, and reframing stressors that can build and lead to caregiver “burnout” if ignored (Folkman, Chesney, McKusick, Ironson, Johnson, and Coates, 1991).

Coping Strategies for Maintaining Health and Well-being

When caregivers are asked to talk about the stress in their lives, they frequently identify their emotions first rather than a specific problem or situation. While recognizing emotions is an important step to maintaining positive emotional health, identifying the situations or events that are problematic is the key to managing stress and preventing caregiver burnout.

Identifying Problems

To identify problems affecting your ability to carry out care-giving responsibilities:

1. Make a list of all the issues or situations that create stress for you and then divide it into two new lists: problems you have some degree of control over (e.g., the food you prepare for meals) and problems with which you have no control (e.g., your loved one’s personality).
   
2. Rank the problems in the two new lists from most bothersome (i.e., creates the most stress) to least bothersome (i.e., creates the least amount of stress). Use the strategies presented below to address the issues on your lists.

Reducing Stress: Things You Can Control

The first step to reducing stress is to review the list of problems over which you have some control.

1. Focus on eliminating the problems that are most bothersome by identifying several ways to implement changes to reduce problems. You will increase your success rate of reducing your stress levels by identifying a variety of solutions for each issue. Conversations with the person receiving care, other family members, and other caregivers are great sources for exchanging ideas to foster change.
   
2. Implement changes. Make a mental note on how the changes help you manage your stress. Changes that reduce stress should be maintained, while those that increase stress should be eliminated. Make changes to relieve more stress accordingly.
   
3. Repeat this exercise periodically to maintain minimum stress levels.

Reducing Stress: Things You Cannot Control

For situations in which you have no control, it is important to maintain a positive outlook.

1. Find the silver lining in every stressful situation. Maybe the person receiving care had fewer emotional outbursts today than yesterday or ate more than usual despite taking twice as long to eat. Celebrate accomplishments, no matter how small.
   
2. Remind yourself that tomorrow is a new day and the chance to approach your situation with renewed energy and vision.
   
3. Visit with another caregiver. Seeing the challenges other caregivers face can put your own experiences in perspective and provide an opportunity to learn new coping strategies.
   
4. Congratulate yourself! Many caregivers experience personal growth and feelings of pride from their care-giving role. Recognize how far you have come in meeting the challenges of providing care and be proud of your accomplishments.

Reducing Stress: Accept Outside Help

Reducing stress can also be accomplished by soliciting help or time away from care-giving through the help of community-based programs, support groups, family, friends, and neighbors.

1. Identify services in your community. Community-based programs such as respite care, home care, and adult day services are designed to provide routine relief to caregivers. Contact your local Agency on Aging to become familiar with the programs available in your area and to inquire about eligibility requirements.
   
2. Join a caregiver support group. Support group participants understand the challenges of the care-giving role and share practical tips, provide emotional support, and help solve challenges unique to care-giving. A support group may be available in your area that is specific to your loved one’s medical diagnosis, such as Alzheimer’s disease or cancer.
   
3. Give family, friends, and neighbors specific tasks to accomplish when they offer to help. Have a list ready for when help is offered. Suggest to the person offering help, “You can…”

1. Take my loved one on an outing so I can spend time alone in my home.
   
2. Come sit with my loved one so I can attend church or go to a special event.
   
3. Call me before you go to the store and I will give you a list of the items I need.
   
4. Prepare a casserole and stay for dinner when you drop it off.
   
5. Make my loved one’s favorite snack and bring it by.
   
6. Stop by and tell us what is going on in your life. We get tired of talking about health problems.
   
7. Join us for a movie date at home or a night playing cards.
   
8. Take our car to get washed or the oil changed.
   
9. Mow the yard, shovel the driveway, or weed the garden.
   
10. Read the newspaper and discuss current events with me or my loved one.

Reducing stress effectively includes taking different approaches to different problems. By taking advantage of the strategies presented in this publication, stress can be managed more effectively and the effects of stress on well-being and health can be reduced.

Care-giving Bookshelf

For more information on how to cope with the stresses and burdens associated with care-giving, look for the following titles at your favorite bookstore or library:

Abramson, A. (2004). The Caregiver’s Survival Handbook: How to Care for Your Aging Parent without Losing Yourself. New York, N.Y.: Perigree Trade.

Meyer, M.M., and Derr, P. (2007). The Comfort of Home: A Complete Guide for Caregivers. Portland, Ore.: CareTrust Publications.

Sherman, J.R. (1996). Preventing Caregiver Burnout (Caregiver survival series). Golden Valley, Minn.: Pathway Books.

Woodson, C. (2007). To Survive Caregiving: A Daughter’s Experience, A Doctor’s Advice on Finding Hope, Help, and Health. West Conshohocken, Pa.: Infinity Publications.

Care-giving Information On line

Additional tips on coping with care-giving stress can also be found on the following Internet websites:

Alzheimer’s Association - www.alz.org

Family Caregiver Alliance - www.caregiver.org

National Alliance for Caregiving - www.caregiving.org

National Family Caregivers Association - www.nfcacares.org

MetLife Since You Care® Guides - www.metlife.com

If you have questions or are interested in other human development information on older adults and their families, contact your local Virginia Cooperative Extension office. Family and Consumer Sciences agents offer a variety of educational programs related to family life, personal fitness, nutrition, and food safety.

If you would like further information on topics concerning older adults please see:

Elder Abuse Alert – Considerations About a Hidden Problem, Virginia Cooperative Extension publication 350-251, http://pubs.ext.vt.edu/350-251/

Substitute Decisions By and For Older Adults and Their Families, Virginia Cooperative Extension publication 350-253, http://pubs.ext.vt.edu/350-253/

Living Options For Adults Needing Assistance, Virginia Cooperative Extension publication 350-254, http://pubs.ext.vt.edu/350-254/

References

Folkman, S., Chesney, M., McKusick, L., Ironson, G., Johnson, D.S., and Coates, T.J. (1991). Translating coping theory into an intervention. In J. Eckenrode (Eds.), The Social Context of Coping (pp. 239-260). New York: Plenum Press.

Reviewed by Novella Ruffin, Extension Specialist, Virginia State University

Other resources in:

• Older Adults

Other resources by:

• Nancy Brossoie

Other resources from:

• College of Human Resources and Education