Preventing Caregiver Burnout- Tips and Support for Family Caregivers

Outside the world of paid work, the people most prone to burnout are caregivers – people who devote themselves to the unpaid care of chronically ill or disabled family members. The demands of caregiving can be overwhelming, especially if you feel you have little control over the situation or that you’re in over your head.

If you let the stress of caregiving progress to burnout, it can damage both your physical and mental health. So if you’re caring for a family member, it’s essential that you get the support you need. The good news is that you’re not alone. Help for caregivers is available.

Family caregivers: What you should know about burnout

Providing care for a family member in need is a centuries-old act of kindness, love, and loyalty. And as life expectancies increase and medical treatments advance, more and more of us will participate in the caregiving process, either as the caregiver, the recipient of care, or possibly both.

Unfortunately, caregiving can take a heavy toll if you don’t get adequate support. Caregiving involves many stressors: changes in the family dynamic, household disruption, financial pressure, and the sheer amount of work involved. The rewards of caregiving – if they come at all – are intangible and far off, and often there is no hope for a happy outcome.

As the stress piles up, frustration and despair take hold and burnout becomes a very real danger. But you can prevent caregiver burnout by following a few essential guidelines:

• Learn as much as you can about your family member’s illness and about how to be a caregiver as you can. The more you know, the more effective you’ll be, and the better you’ll feel about your efforts.
• Know your limits. Be realistic about how much of your time and yourself you can give. Set clear limits, and communicate those limits to doctors, family members, and other people involved.
• Accept your feelings. Caregiving can trigger a host of difficult emotions, including anger, fear, resentment, guilt, helplessness, and grief. As long as you don’t compromise the well-being of the care receiver, allow yourself to feel what you feel.
• Confide in others. Talk to people about what you feel; don’t keep your emotions bottled up. Caregiver support groups are invaluable, but trusted friends and family members can help too. You may also benefit from seeing a therapist or counselor.

Contact us today fore respite, counseling, education, training and support at 1-800-209-4342.

If it becomes necessary to place your family member in a nursing home, counseling or coaching services may help you and your family deal with feelings of guilt, grief, anger, depression, and anxiety,.  Support can be obtained through family and group counseling, support groups, and individual therapy. If needed, your physician can help you evaluate your options, though planning for long-term care should be discussed well before in becomes necessary.

Patient Directed Treatments:  An individual with Alzheimer’s disease may exhibit difficult behaviors such as severe mood swings, verbal or physical aggression, combativeness, repetition of words, and wanderings.  Efforts to maintain or improve the patient’s behavior can help improve the quality of life for the patient, your family, and you.

The following techniques are designed to manage the functional and behavioral deterioration of a patient with Alzheimer’s disease.  These strategies have worked for many families, often delaying institutionalization.  Talk with your physician about strategies that may help you.

Pharmacological Treatments:  Several medications are currently on the market that help to delay the severity of cognitive impairment as well as treat the behavioral symptoms of Alzheimer’s disease.  Talk to your family member’s physician to discuss drug therapy, and consult the American Association for Geriatric Psychiatry for more information.

Independence Promoting Strategies:  Interventions designed to improve patients’ functioning also have been shown to improve Alzheimer’s disease symptoms.  Such strategies help the patient retain mental and physical abilities and help with daily activities of hygiene, dressing, grooming, and eating.  The techniques use incentives, verbal and physical prompting, and physical guidance.  For example, having an Alzheimer’s patient choose the specific activity to engage in for the day promotes independence.

Strength/Mobility Enhancement:  The well-known benefits of exercise apply to the person with dementia as well. Simple stretches, scheduled walking, or peddling a stationary bicycle all can help prolong mobility, decrease agitation, and improve sleep in the mild to moderately diseased patient.

Sleep Management:  Sleep problems associated with Alzheimer’s disease can be a major source of caregiver stress and fatigue.  Studies have shown that a period of brihgt light may decrease an individual’s agitation and improve sleep patterns.  Other strategies for enhancing nighttime sleep include maintaining a darkened environment at night, providing an early evening warm bath, and limiting daytime napping.

White Noise:   White noise, a continuous, monotonous, soft background noise, has been shown to modestly decrease verbal agitation in some patients.  In addition to white noise generators, recordings of ocean waves, flowing streams, or other nature sounds may be soothing for the patient.  Music therapy may also help by stirring memories and emotions.

Lighting:  Dimming lights at mealtime may decrease mealtime agitation and increase food consumption.

Visual Cueing: Visual cueing, such as posting a picture of a bed on the door of  the patient’s bedroom, can help a person with dementia find his or her way around a home as memory begins to fade. Pictures may provide more effective cues for direction than words.

Tomorrow I will post an additional eight items that are useful in helping families with loved ones needing long-term care.

In today’s post on Depression Later in Life, I will focus on the fact that depression is treatable.

Most depressed elderly people can improve dramatically from treatment. In fact, there are highly effective treatments for depression in late life.  Some treatment prescribed by physicians include:

• Psychotherapy
• Antidepressant medications
• Electroconvulsive therapy (ECT)

Antidepressants work by increasing the level of neurotransmitters in the brain.  Neurotransmitters are the brain’s “messengers.” Many feelings, including pain and pleasure, are a result of the neurotransmitters’ function.  When the supply of neurotransmitters is imbalanced, depression may resul.

A frequent reason some people do not respond to antidepressant treatment is because they do not take the medication properly.  Missing doses or taking more that the prescribed amount of the medication compromises the effect of the antidepressant.  Similarly, stopping the medication too soon often results in a relapse of depression.  In fact, most patients who stop taking their medication before four to six months after recovery will experience a relapse of depression.

Usually, antidepressant medication is taken for a least six months to a year.  Typically, it takes four to twelve weeks to begin seeing results from antidepressant medication.  If after this period of time the depression does not subside, the patient should consult his or her physician.  Antidepressant drugs are not habit-forming or addictive. And because depression is often a recurrent illness, it usually is necessary to stay on the medication for six months after recovery to prevent new episodes of depression.

Electroconvulsive therapy (ECT) is a treatment that unnecessarily evokes fear in many people.  In reality, ECT is one of the most safe, fast-acting and effective treatments for severe depression.  It can be life saving.  ECT often is the best choice for the person who has a life-threatening depression that is not responding to antidepressant medication or for the person who cannot tolerate the medication.

After a thorough evaluation, a physician will determine the treatment best suited for a person’s depression.  The treatment of depression demands patience and perseverance fore patient and the physician.  Sometimes several different treatments must be tried before full recovery.  Each person has individual biological and psychological characteristics that require individualized care.

In tomorrow’s final post on Depression Later in Life, I will discuss caring for the depressed person.

This week I am featuring a four  part series on Depression in Late. Depression is not a natural part of aging and not just a passing mood.

Sadness associated with normal grief or eveyday “blues” is different from depression.  A dad or grieving person can continue to carry on with regular activities.  The depressed person suffers from symptoms trhatinterfere with his or her ability to function normally for a prolonged period of time.

Recognizing depression in the elderly is not always easy.  It is often difficult for the depressed older adult to describe how he or she is feeling.  In addition, the currently population of older Americans came of age at a time when depression was not understood to be a biological disorder and mental illness.  Therefore, some elderly fear being labeled “crazy”, or worry that their illness will be seen as a character weakness.

The depressed person or their family members may think that a change in mood or behavior is simply “a passing mood”, and the person should just “snap out of it”.  But someone suffering from depression cannot just “get over it”.

Depression is a medical illness that must be diagnosed and treated by trained professionals.  Untreated, depression may last months or even years.

Untreated depression can:

• Lead to disability
• Worsen symptoms of other illnesses
• Lead to premature death
• Result in suicide

When it is properly diagnosed and treated, more than 80 percent of those suffering from depression recover and return to their normal lives.  The most common symptoms of late-life depression include:

• Persistent sadness (lasting two weeks or more)
• Feeling slowed down
• Excessive worries about finances and health problems
• Frequent tearfulness
• Feeling worthless or helpless
• Weight changes
• Pacing and fidgeting
• Difficulty sleeping
• Difficulty concentrating
• Physical symptoms such as pain or gastrointestinal problems

One important signe of depression is when people withdraw from their regular social activities. Rather than explaining their symptoms as a medical illness, often depressed persons will give different explanations such as “It’s too much trouble,” “I don’t feel well enough,” or “I don’t have the energy.”

For the same reasons, they often neglect their personal appearance, or may begin cooking and eating less.  Like many illnesses, there are varying levels and types of depression.  A person may not feel”sad” about anything, buy may exhibit symptoms such as difficulty sleeping, weight loss, or physical pain with no apparent explanation.  This person still may be clinically depressed. Those same symptoms also may be a sign of another problem – only a doctor can make the correct diagnosis.

Tomorrow, I will feature Part Two of this series on Depression in Late Life.

For Immediate Release Contact: Elayne Forgie, Pres.
December 21, 2011 :     elayne@eldercareathome.org

ElderCare at Home Joins Nationwide Campaign to Encourage Discussion and
Planning with Older Adults during the Holidays

Cost Savings and Better Health Outcomes Cited as Reasons for Older Patients and their Caregivers to Actively Plan for Hospital Stays

West Palm Beach, Florida – Returning home from a hospital stay can result in unexpected challenges for many seniors and as a result, millions of older Americans are spending billions of dollars on health care costs every year that could be avoided through simple planning and preparation prior to being admitted to the hospital. Nearly one in five Medicare patients discharged from the hospital is readmitted within 30 days due to an injury resulting from medical management – not the underlying disease – costing over $26 billion every year. Some studies have found that between 40 percent and 50 percent of readmission are linked to social problems and lack of community resources.

This holiday season, Eldercare Locator, a public service of the U.S. Administration on Aging that is administered by the National Association of Area Agencies on Aging (n4a), launched its 9th Annual Home for the Holidays campaign encouraging older adults, caregivers and their families to use their time together this holiday season to discuss potential hospital visits and start planning ahead for a smooth transition from the hospital to the home. ElderCare at Home is supporting the campaign by raising awareness for more effective care transitions in the Palm Beach County area

“This holiday season is an ideal time for families to get together and plan ahead,” said Elayne Forgie, President at ElderCare at Home. “We strongly encourage Palm Beach County families to take some time to address these issues so that heading into the New Year, when medical issues arise, a plan is in place.”

Eldercare Locator and the United Hospital Fund’s Next Step in Care (www.nextstepincare.org) released a consumer guide that can be used by Palm Beach County families and caregivers to lead the discussion this holiday season. The guide, which provides planning tips for pre-hospital check-in as well as post-checkout from the hospital, is available here.  Some of the questions the Eldercare Locator encourages the public to address prior to being admitted to a hospital include: What do you need to bring? If you are not going to be well enough to care for yourself when you are released, where will you go? Will you need help getting around? Will you need equipment and supplies? Will you be able to take the appropriate medications without help those first days out of the hospital? Who will assist you? How long will you need assistance?

“As we age, the likelihood of a hospital stay increases and it is critical to plan before that time arrives,” said Kathy Greenlee, Assistant Secretary for Aging, U.S. Department of Health and Human Services. “We encourage families and caregivers to take advantage of their time with older relatives this holiday season to talk about the brochure’s important cost-saving and potentially life-saving tips.”

ElderCare at Home offers both pre and post hospital evaluations, guidance, support and information. You can reach us at 800-209-4342.

About Eldercare Locator
The Eldercare Locator is the first step to finding resources for older adults in any U.S. community and a free national service of the U.S. Administration on Aging (AoA) that is administered by the National Association of Area Agencies on Aging (n4a). Contact the Eldercare Locator at 800.677.1116 or www.eldercare.gov.

About Next Step in Care
The United Hospital Fund’s Next Step in Care website (www.nextstepincare.org) has guides for family caregivers on many aspects of transitions, including medication management, discharge checklists, hospice and palliative care and many others. The guides are free and available in English, Spanish, Chinese and Russian.

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ElderCare At Home has an excellent resource page for all things Dementia related and Alzheimer’s- check it out here!

One of society’s most feared medical conditions is Alzheimer’s disease. So many times, a person is misdiagnosed or never diagnosed at all.  Those individuals are then left untreated and continue to decline. The toll this takes on the patient and their family is unimaginable.

At ElderCare at Home, our primary goal is you to assure you receive an accurate diagnosis as early as possible; provide you and your family with all available resources and possible interventions, as well as to educate, train, reassure, support and advocate for you and your family as you pass through each stage of the disease.  Our goal is to keep you at home, with your family, for as long as it is financially and physically possible.  We do this by providing superior Alzheimer’s Care at Home; professional geriatric care management and private duty home care services in addition to:

Education
ElderCare at Home is a dementia specific geriatric care management and private duty home care agency.  Our affiliated companies, www.AlzheimersTraining.com and The Alzheimer’s Care Resource Center provide very comprehensive services, education and training for the newly diagnosed patient and their caregiver.  We focus on understanding the individual patients ever changing behavior, anticipating new issues that are likely to arise, proactively manage individual patient and family dynamics before they become a crisis, and provide respite care through our Reach Out For Respite Program.  Our services have been proven to delay nursing home placement, help to reduce physician office and emergency room visits, and help to reduce the strain on the primary, family caregiver.

Safety
Our professional geriatric care managers are registered nurses, licensed practical nurses, social workers and certified geriatric care managers with years of experience working directly with patients and families living with Alzheimer’s disease.  One of the first things we do is to make sure the patient’s home is safe.  Our home safety evaluation is proprietary and was designed to address the specific safety issues faced by our patients and their caregivers. Safety concerns do not just focus on what happens in the home, but also address what happens when the patient leaves the home.  Our team makes sure that all of our families have a solid plan in place.

The Independence You Need. The Peace of Mind You Desire.

When a family reaches out to ElderCare at Home, one of the first things they want to know is how we can help them keep their loved one at home and independent?  For over 20 years our management team has helped thousands of families in Palm Beach, Broward and Martin counties not only keep their loved one in the place they most want to be, in their own home, but to give the patient and the caregiver as  much independence as possible.  Our services provide families across the country with the peace of mind they need and they desire.  To learn more about how ElderCare at Home or the Alzheimer’s Care Resource Center can help you, call our 24 hour Alzheimer’s Care Crisis Line at 800-209-4342.

Dressing

• Simplify choices. Keep the closets free of excess clothing. A person may panic if clothing choices become overwhelming. If appropriate, give the person an opportunity to select favorite outfits or colors, but try offering just two choices.
• Organize the process. Lay out clothing in the order that each item should be put on. Hand the person one item at a time while giving short, simple instructions such as “Put on your shirt,” rather than “Get dressed.”
• Pick comfortable and simple clothing. Cardigans, shirts and blouses that button in front are easier to work than pullover tops. Substitute Velcro® for buttons, snaps or zippers, which may be too difficult to handle. Make sure that clothing is loose fitting, especially at the waist and hips – and choose fabrics that are soft and stretchable.
• Choose comfortable shoes. Make sure the person has comfortable, non-slip shoes.
• Be flexible. If the individual wants to wear the same outfit repeatedly, buy duplicates or have similar options available. It’s all right if the person wants to wear several layers of clothing, just make sure he or she doesn’t get overheated. When outdoors, make sure the person is dressed for the weather. Offer praise, not criticism, if clothing is mismatched.
• Be patient. Rushing the person can cause anxiety and frustration.

Grooming

A person with dementia may forget how to comb hair, clip fingernails or shave. He or she may forget what the purpose is for items like nail clippers or a comb.

• Maintain grooming routines. If the person has always gone to the beauty shop or a barber, continue this activity. If the experience becomes distressing, it may be possible to have the barber or hairstylist come to the person’s home.
• Use favorite toiletries. Allow the person to continue using his or her favorite toothpaste, shaving cream, cologne or makeup.
• Perform tasks alongside the person. Comb your hair, and encourage the person to copy your motions.
• Use safer, simpler grooming tools. Cardboard nail files and electric shavers can be less threatening than clippers and razors.

Diagnosing Alzheimer’s disease as early as possible can help patients and their families to better prepare for the progression of the disease. But diagnosing Alzheimer’s can be a complicated process, given that it is only one of a group of brain diseases known as dementia, meaning neurological disorders that rob the mind of its intellectual ability.

If you or a family member needs to be evaluated for Alzheimer’s disease, just as you would not see a podiatrist for a cardiac problem, you should be sure to choose the best clinician to diagnois your neurological problem.

ElderCare at Home has been helping families find the best clinicians to help make a proper diagnosis and receive appropriate care for almost 20 years. There are various specialists that we work with in West Palm Beach, Boynton Beach, Lake Worth, Palm Beach Gardens, Boca Raton, Jupiter and Delray Beach that we can refer you to. Remember, with ElderCare at Home by your side, you are never alone. Call us today at 800-209-4342.

• A geriatrician, a medical doctor who specializes in the care of elderly patients
• A neurologist, a medical doctor who specializes in diseases of the brain or nervous system and can assess different types of dementia
• A psychiatrist, a medical doctor who specializes in mental disorders and can diagnose a mood disorder, such as severe depression that may mimic Alzheimer’s symptoms.
• A psychologist, a licensed medical professional (a PhD or PsyD) who can test such mental functions as logic, memory, and concentration