According to the National Council of Certified Dementia Practitioners, there are 11 special skills that make up a successful dementia care provider:
1. High self-esteem
5. Open-mind – good listening skills
7. Sense of humor
8. Positive attitude
9. Sense of self responsibility
10. Willingness to learn and change
11. More desire to give than receive
Having these special skills will help you to manage your stress level more easily than not having these skills. It does not mean that it will be a non-stress life; just raises your possibilities of making it more manageable.
Being a caregiver requires a thick-skin and a lot of patience. There may be some days that you can handle every act of the individual, and other days where you feel you just can’t handle one more second. According to the Alzheimer’s Association, there are 10 symptoms of caregiver stress:
1. Denial – Denial about the disease and its effect on your loved one who has dementia. You believe that they will get better.
2. Anger – Anger at your loved one with dementia or frustration that he/she can’t do things that they used to do. Believing that they are just being stubborn and having behavior issues; when, in fact, they don’t remember how to do things anymore.
3. Social withdrawal from friends and activities that they used to do and enjoy.
4. Anxiety – Anxiety about the future and facing another day. Fear about future needs of the individual and if they will be able to handle it.
5. Depression – Depression that breaks your spirit and affects your ability to cope; just not caring anymore.
6. Exhaustion – Exhaustion that makes it nearly impossible to complete necessary tasks.
7. Sleeplessness – Caused by the never-ending list of concerns. Your brain can’t stop thinking and worrying about everything.
8. Irritability – Leading to moodiness and triggers negative responses and actions.
9. Lack of concentration making it difficult to perform tasks.
10. Health problems that begin to take a mental and physical toll.
If you say, “I have that” to any of the above, it’s time to start learning and performing coping skills, talk to your physician and start setting up help.
I can almost see those wheels turning an you thinking, “Ya, right! Lady, you don’t have a clue!” But…I do! And, I also know that you NEED to learn techniques and start reaching out to take care of YOU! Caregivers are upping their mortality rates due to the amount of stress we go through taking care of our loved ones and not taking care of ourselves!
So, here are some ways to manage your stress:
*Know what resources are available to you: Contact other family members. Sometimes family thinks you have it and they don’t understand the stress and how difficult it is to take care of someone with dementia. Reach out to them. Ask neighbors for an hour here or there. There are adult day care programs; in-home assistance programs with aides coming in to assist in taking care of your loved one, shopping, cooking, helping with doctor’s appointments, etc.; home health care. Check in neighborhood groups and out in the community at your churches and libraries to find someone to come in a couple hours a day or just a couple days a week to give you a break. You can also contact the Alzheimer’s Association for help.
* Have a good support system. You need someone to be able to vent to and go to for ideas. Coming to support groups and hearing others going through the same things you are.
* Use relaxation techniques: You can do breathing exercises; doing proper breathing, which is like a baby…it is called abdominal breathing where you inhale and push out your stomach and while you are exhaling push your stomach in (easiest way to describe it). You can also just focus on your breathing, counting up to 10 with each inhalation. Every time your mind goes off on a thought, start at 1 again. Taking just 5 minutes to do this can help tremendously. Counting to 10! My mom always did this when I was a kid and I thought she was nuts. It really has a calming effect. Just take yourself away from the situation and count to 10 to clear your mind so you can attend to the situation. Visualization – mentally picturing a place or situation that is peaceful and calm. Meditation is another option – start even at 6 minutes a day to let go of stressful thoughts and relax your mind. Yoga is another good way to relax and learn correct breathing techniques. Progressive muscle relaxation – tightening and relaxing muscle groups. Picturing your muscles “melting like butter.” You basically start at your head and tighten up all muscles and grimace as hard as you can for approximately 5 seconds, then relax and feel the difference between the tension and relaxation. Slowly move down your body to each large muscle group and tighten and release an enjoy the feeling of the relaxation and notice the difference.
* Get moving – exercise of any form helps release endorphins, which are your body’s natural pain killers. It will help reduce stress and improve overall well-being.
* Find time for yourself – You CAN do this. I have been there and I know it ALWAYS feels like you can’t, but you CAN and you MUST! When there is a WILL, there is a WAY!!
* Take care of yourself! This goes along with taking time for yourself. You also need to maintain your health by eating healthy, drinking plenty of water, exercise, staying away from alcohol and tobacco. Make sure you stay on schedule with your doctor’s appointments.
* Become educated on dementia. The more you know, the easier it is to know how to help your loved one and to cope with what is going on.
* Make legal and financial plans. Putting all legal an financial issues into order early in the disease is important so that the individual with dementia can be a part of it. Having everything in order will ease much stress later on.
According to the NCCDP:
Understand more about stress:
Recognize your major sources of stress at present. What things make you the most stressed?
Understand how this stress affects you.
Anticipate and plan for periods of stress.
Know how much stress is too much for you.
Adopt a systematic problem-solving approach:
Define your problem-specifically – try to be objective.
Break it down into manageable components.
Approach projects one state at a time.
Develop, evaluate and execute a course of action.
Recognize and accept your own feelings:
Express the way you are feeling openly with others.
Accept your feelings.
Be aware of past experiences which effect your feelings.
Develop new effective behavioral skills:
Be assertive – learn to say ‘NO!’
Avoid procrastination, “Do it today!’
Manage your time effectively.
Avoid being a perfectionist.
Practice rational thinking.
Practice goal planning.
Establish and make use of a good social support network:
Ask for help ad accept it when offered.
Deliberately cultivate good relationships.
Talk to people: family, old friends new friends.
Maintain a healthy lifestyle:
Take regular physical exercise.
Maintain a healthy, balanced diet.
Deliberately seek out change of pace, and new activities in your life.
Make time to relax and enjoy yourself:
Set aside time each day to do something you enjoy.
Plan breaks: lunch breaks, weekends, holidays.
Develop engaging hobbies and recreational activities.
Set aside time for reflection and spiritual development:
Set aside time for reflection and meditation.
Reassess your values. What is really important in your life?
Review your goals in life. What are you working toward?
Don’t get overwhelmed looking at all these ideas. Take one at a time and work it into your life. If you take little baby steps at a time, it will stick with you longer. Get used to following one of these ideas at a time until it is a habit, then add another idea to your day.
These all help, but sometimes, especially when you are new to caregiving, you just don’t know what you are doing wrong and/or what else you could be trying. Are you being too hard on your loved one, not helping them in the right way; too hard on yourself? Why aren’t things going how you think they should, etc. Here are 10 “Real-Life Strategies for Dementia Caregiving,” according to Family Caregiver Alliance:
1. Being Reasonable, Rational and Logical Will Just Get You into Trouble:
When someone is acting in ways that don’t make sense, we try to ration with the individual. However, the person with dementia can’t be rational. They are not able to respond to our arguments, no matter how logical. Therefore, straightforward, simple sentences about what is going to happen are usually the best.
2. People with Dementia Do Not Need to Be Grounded in Reality!
When someone has memory loss, he/she often forgets important things, such as their parent is deceased. When we remind them of this loss, we remind them about the pain of that loss also. When someone wants to go home, reassuring them that they are not at home often leads to an argument. Redirecting and asking someone to tell you about the person he has asked about or about his home is a better way to calm a person with dementia.
3. You Cannot Be a Perfect Caregiver!
You are human. Nobody is perfect. There is no such thing as a perfect parent, nor a perfect caregiver. You have the right to the full range of human emotions, and sometimes you are going to be impatient or frustrated. Learning to forgive your loved one as well as forgiving yourself is essential in the caregiving journey.
4. Therapeutic Lying Reduces Stress:
When someone has dementia, honesty can lead to distress both for us and the one we are caring for. For example, does it really matter that your loved one thinks she is the volunteer at the day care center? It is okay to tell your loved one that the two of you are going out to lunch and then “coincidentally” stop by the doctor’s office on the way home to pick something up a a way to get to the doctor?
5. Making Agreements Doesn’t Work:
If you asked your loved one to not to do something ever again, or to remember to do something, it will soon be forgotten. For people in the early stages, leaving notes as reminders can sometimes help, but as the disease progresses, this will not work. Taking action, rearranging the environment, rather than talking and discussing, is usually a more successful approach. As an example getting a tea kettle with an automatic “off” switch is better than warning someone of the dangers of leaving the stove on.
6. Doctors Often Need to Be Educated By You:
Telling the doctor what you see at home is important. The doctor can’t tell during an examination that your loved one has been up all night pacing. Sometimes doctors, too, need to deal with therapeutic lying; e.g., telling the patient that an antidepressant is for memory rather than depression.
7. You Can’t Do it All. It’s OK to Accept Help Before You Get Desperate:
When people offer to help, the answer should always be “YES.” Have a list of things people can do to help you, whether it is bringing a meal, picking up a prescription, helping to trim the roses, or staying with your loved one while you run an errand. This will reinforce offers of help. It is harder to ask for help than to accept it when it is offered, so don’t wait until you “really need it” to get support.
8. It is Easy to Both Overestimate and Underestimate What Your Loved One Can Do:
It is often easier to do something for our loved ones than to let them do it for themselves. However, if we do it for them, they will lose the ability to be independent in that skill. On the other hand, if we insist individuals do something for themselves and they get frustrated, we just make our loved one’s agitated and probably haven’t increased their abilities to perform tasks. Not only is it a constant juggle to find the balance, but be aware that the balance may shift from day to day.
9. TELL, DON’T ASK!:
Asking, “What would you like for dinner?” may have been normal at another time. But now we are asking our loved one to come up with an answer when he/she might not have the words for what they want, might not be hungry, an even if they answer, might not want the food when it is served after all. Saying, “We are going to eat now” encourages the person to eat and doesn’t put them in the dilemma of having failed to respond.
10. It is Perfectly Normal to Question the Diagnosis When Someone Has Moments of Lucidity:
One of the hardest things to do is to remember that we are responding to a disease, not the person who once was. Everyone with dementia has times when they make perfect sense and can respond appropriately. We often feel like that person has been faking it or that we have been exaggerating the problem when these moments occur. We are not imagining things – they are just having one of those moments, to be treasured when they occur!
In closing, try and remember these things to help decrease your stress. You are only human and can take only so much. That is the ipo