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Care and Care Alike As the number of Americans responsible for the care of a loved one increases, so does the need to reprioritize self-care 
The term "informal" or "family" caregiver refers to anyone who provides unpaid assistance to a loved one who is, in some degree, incapacitated and needs help: a wife with cancer; a grandfather with Alzheimer's; a brother with a traumatic brain injury; a friend with AIDS. According to the Family Caregiver Alliance (FCA), there are approximately 52 million family caregivers in the U.S. providing either short- or long-term care for an ill or disabled loved one aged 20 or older, with nearly one in five providing more than 40 hours of care per week. These numbers continue to grow due to the high cost and limitations of heath care, and as the Baby Boomer generation ages. "You don't have to be doing it 24/7," says Donna Schempp, program director for the San Francisco-based FCA. "If you are doing things like bringing over meals or helping with laundry, you should identify as a caregiver." But the caregiver's role also can include everything from full-time cooking, cleaning, running errands and handling bills, to feeding, bathing and dressing a loved one. In some cases, it also means providing complex medical care, such as administering multiple shots and medications, flushing ports and dressing wounds. In addition, they often provide emotional support and manage erratic behavior. "It's a really tough role," says Kimberly Stump-Sutliff, registered nurse and the associate medical editor for the American Cancer Society (ACS). "A leukemia patient in one of my support groups, whose wife had lymph cancer 10 years ago, said that he'd rather be the one with cancer than the caregiver any day." In light of the overwhelming responsibilities, most caregivers tend to disregard their own healthcare, often skipping routine checkups, eating poorly and failing to get adequate sleep, exercise and personal time. The higher incidence of stress contributes to increased Cortisol levels, which make caregivers more susceptible to problems like high blood pressure, compromised immune function and cognitive impairment, and sleep deprivation can lead to weight gain, fatigue and mood disorders. "Caregivers have a 50 percent higher incidence of depression," Schempp says. The solution for prevention is for caregivers to make self-care a top priority. It may sound selfish or impossible when a loved one is gravely ill, but it's impossible to provide optimal care when the caregiver gets sick, says John W. Anderson, author of "Stand by Her: A Breast Cancer Guide for Men" (AMACOM, 2009). (Anderson had such poor immune function while caring for his wife as she fought breast cancer, that he developed Lyme disease and tested positive for exposure to TB.) If you are a caregiver, it is imperative to keep up with your own medications and doctor's visits. Consider following the ACS "Nutrition and Physical Activity Guidelines" - maintain a healthy weight; eat a diet rich in produce and whole grains; limit alcohol consumption; get 30 to 60 minutes of exercise at least five days a week; and don't smoke. As a result, not only will you be a more capable caregiver, you will reduce your own risk of developing multiple cancers, heart disease, diabetes and other illnesses. In addition, taking care of the body includes taking care of the mind. That could mean reading a book, finishing a project or going out to dinner with friends. "It's easy to think that you always have to be there, but you need breaks to recharge your batteries," says Anderson, "and the truth is that your loved one needs breaks from you too." Make the time for self-care by asking for help from family and friends before you desperately need it - and saying yes when help is offered. In addition, there are numerous community and federal resources, such as the National Family Caregiver Support Program, which helps caregivers by providing free chore services, time off and counseling. Caregivers also should learn more about a loved one's condition and ways to make the job easier. This may be as practical as having a physical therapist demonstrate how to lift a loved one without stressing back muscles. Or it may be learning new behaviors that at first seem counterintuitive, Schempp says. "For example, we often spend a lot of time trying to make dementia patients see the 'truth' - I'm your daughter, not your wife - rather than just going with where they're at. But constantly correcting them just makes them feel put down, angry and anxious, and the reality is that they won't be able to remember later anyway because they have dementia." More information, as well as support networks and discussion forums specifically for caregivers, can be found online at Caregiver.org, Cancer.org and LotsaHelpingHands.com. |
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