Forgetting oneself can be the norm for caregivers dealing with the day-to-day struggles of an Alzheimer’s patient. The patient’s health needs are so immediate, so apparent and unavoidable, that caregivers may brush aside their own health concerns.
While it's understandable that caregivers neglect themselves, doing so can be dangerous. Caregivers are diagnosed with depression at twice the rate of non-caregivers and face increased risks for other health problems as well. A caregiver’s physical and psychological risks demand attention and care equal that of the Alzheimer’s patient.
Stress
Stress might be caused by any number of the hardships caregivers face. Common among stress factors are poor diet, lack of exercise and insufficient sleep. Many times the patient’s limited or waning abilities cause these issues. These problems manifest themselves in both physical and psychological ways. Poor eating habits, for example, wreak havoc on a person’s physical wellbeing, but they also may affect a person’s mental health in unexpected ways. If the caregiver doesn’t have time to cook themselves a satisfying meal they may find themselves resenting the patient and in turn, guilty for that resentment.
Stress is a perfectly understandable byproduct of caring for an Alzheimer’s patient. It does not mean that the caregiver does not love the patient enough or doesn’t have the ability or desire to provide excellent care. Stress is simply stress, and it is an emotion to which caregivers should pay attention. Caregivers should view stress an indicator that things need to change—their bodies’ very own warning system.
While caregivers cannot change the realities of living with an Alzheimer’s patient, they can change how they react to and deal with those realities, and in turn may actively create happier, healthier versions of themselves.
Common Stresses and How to Cope
Many caregivers worry about the future or feel sadness when remembering the past, when their loved one was independent and healthy. These feelings are natural and should be addressed by the patient’s doctor. The doctor may offer the caregiver support or point in the direction of others who maybe be able to help the caregiver sort through these difficult feelings. Other stresses seem mundane in comparison but are no less valid. These stresses about the day-to-day realities of Alzheimer’s care can often overwhelm a caregiver. Making small changes can result in a less stressful life for patient and caregiver.
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Mealtimes
If mealtimes are a chore, the caregiver may opt for a quick and easy (and often unhealthy) snack in between trying to get the patient to eat or may forgo the meal altogether. So what is the caregiver to do when they can’t get a decent bite to eat because they are too busy coaxing the patient to swallow another forkful? Let lunchtime take an hour. Sit with the patient, creating mealtimes as social events to be enjoyed rather than obligatory events to be rushed. Choose food items the patient enjoys and utensils he or she can use independently. Savor your food and the time spent socializing around the table.
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Exercise
Caregivers pay a physical and psychological price for not exercising. If caregivers would like to attempt physical activity with a reluctant patient, set realistic goals and start small. Try a walk up and down the driveway before a walk around the block. Consider activities the patient enjoys and alternatives to traditional exercises. Perhaps the patient and caregiver could garden together. If the patient is sensitive to heat or cold, walking around a mall instead of around the block might provide the perfect solution. If the patient is not able to partake in physical activity, it becomes more difficult for the caregiver to exercise, but is no less important. Why not try an exercise tape while the patient naps? Exercise will give the caregiver more energy for when the patient wakes up.
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Sleep
Routine is the best way for the patient and caregiver to establish healthier sleep patterns. Establishing a set bedtime or rituals, such a brushing teeth, dimming lights or reading will help signal to the patient that sleep is on its way. Eliminating light and sound from the patient’s room helps ease the transition from wakefulness to sleep—even the light of a digital clock might keep some people awake. Avoiding caffeine in the late afternoon and evening and eating certain foods can lead to a better sleep. Remember after Thanksgiving dinner, when all you wanted was a nap? You can’t cook a Thanksgiving feast every night, but you can eat foods that induce sleep. Tryptophan, the sleep-inducing amino acid found in turkey, is present in other poultry and meat, dairy products, potatoes and bananas. A glass of milk before bed just might allow a more restful, recuperative sleep for patient and caregiver alike.
Identifying the Problem
Many times, identifying the source of stress is the first and most difficult step in managing the stress. The problems may not be as obvious as they seem. The first problem a caregiver might consider is “I’m stressed and irritable.” When wondering about the cause, caregivers might conclude that they don’t get enough exercise as they used to. Accepting that as the most basic problem is an easy trap in which to fall. It is all too easy, at that point, for the caregiver to think, “Well I can’t go to the gym (or can’t go for my nightly run or can’t attend yoga class) because I have to be the caregiver.” The only way to solve the problem, however, is to dig deeper.
The root of that problem might be that the caregiver is taking on more responsibility than manageable, perhaps due to lack of support or the assumption that he or she is the only person who can adequately care for the patient. Thinking about the problem in that way may at lead to guilt (“How could I think about taking time for the gym when I should be at home?”).
It is important to remember, however, that personal needs do not disappear when one becomes a caregiver. A caregiver’s health, mental and physical, needs to be a priority. Perhaps accepting or asking for a helping hand could be the true solution for stress and irritability.
Seeking and Accepting Help
If help is not forthcoming, caregivers may be reluctant to seek it out. Some caregivers might assume that any requests they make will not be answered so they don’t bother to try, but specific requests lead to effective communication and will help your cause. When talking to a sibling, for example, don’t start the conversation with an accusatory, blanket statement like “You never help,” but rather, use constructive “I” statements. Try, “I would really like to have dinner with a friend this weekend. Could you stay with Mom for a few hours?” You will be much more likely to get through to someone if you remain clam and direct.
For the caregiver accustomed to doing everything on his or her own, accepting help may prove difficult. If a friend offers to cook dinner a few nights a week, caregivers might feel guilty that they can’t do it all themselves; if a neighbor offers to give them a night off, they might hesitate, running countless “what-if” situations through their minds. It may help to remember that others are capable of providing care and that there is no shame in enjoying a night at the movies.
Caregivers should utilize all the resources at hand, for the patient’s health and their own. An Alzheimer’s patient will benefit more from a relaxed and cheerful caregiver who asks for help than a stressed caregiver who does everything on his or her own.
Resources for caregivers include not only their family and friends, but also their doctors and nurses. The Alzheimer’s Disease and Memory Disorder Center at Rhode Island Hospital is one such resource caregivers can turn to for support and information.
