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The Eldercare Advocate: Caregivers, Are You Feeling Squeezed?

May 5, 2020|advocacy, boundaries, breathing, caregivers, confinement, coronavirus, COVID19, Eldercare, elders, healthier you, Journaling, mindfulness, positivity, Prioritize, Savoring, self-care, STOP technique, stress, wellbeing, wellness strategies

Caregivers Can Set Boundaries to Allow for Self-Care

In addition to the usual caregiver challenges that are well understood, the present situation with COVID-19 may be adding another layer which may exacerbate an already difficult situation. People are isolated and feeling alone. Families may no longer be able to provide the same amount of care. Caregivers may have fallen ill, other may be quarantined because of exposure or members of their family have conditions that place them in a vulnerable state and thus they are reluctant to continue in person visits to older family members. Routines, which are so important for those with impaired cognition, are disrupted.  Depending on the level of cognitive impairment, some persons with dementia may not understand the reason they are now more isolated which may exacerbate their depression and hence their cognitive decline.

One of the most important issues that caregivers face is guilt, that which is self-imposed as well as guilt from family and friends. The support systems that were available to many caregivers may be more difficult to access at this time. The self-blame game:  am I doing enough? can I do more? Is exacerbated. Few remember the sacrifices they are making and take the time to honor themselves and the contributions they are making in the life and care of a loved one. One may think of this as bragging, boasting, patting yourself on the back. But there is nothing wrong with patting yourself on the back as an acknowledgement, an honest appraisal, of the contribution you are making in support of another. Consider it self-recognition rather than bragging or self-promotion. Many caregivers feel they have no choice in the situation with unrealistic expectations of the extent to what they should endure and what they should be giving in terms of care. 

A good way to take stock of the situation and thwart against self-guilt and self-blame is to utilize a technique known as the STOP technique. I refer to it as a kind of momentary mindfulness. When you feel or hear yourself condemning or criticizing yourself for short-temperedness, snapping, feeling like you don’t want to and can’t carry on with this situation any longer. Literally STOP!!!! Recognize and acknowledge the negative thought or emotion. You may possibly want to write it down. Take a few deep healing breaths, Observe and acknowledge the negative thought for what it is, Proceed with what you were doing by acknowledging the positive, and reframe what just happened by noting that it was just a moment in a larger scheme of all the positives.

Research has shown that mindfulness impacts positive changes in the brain. The acclaimed book by Rick Hanson, PhD, neuropsychologist and coauthor of Buddhe’s Brain: The Practical Neuroscience of Happiness, Love and Wisdom (2009) refers to that well known theory in neuroscience that Neurons that fire together wire together. In other words, if you change your thought patterns you can actually change your brain’s physiology. It is not suggested that you ignore your negative ideas or thoughts, but tif you make a concerted effort at the moment you are experiencing them to reframe them into a more positive approach and savor that positive idea or feeling for at least 10 seconds, you can create a transformational shift in your attitude.

Try not to fall into the trap of comparing your deeds against the acts of others, societal, cultural or religious expectations. Mother Theresa was a Saint and there are few Saints among us; in all likelihood there will not be any Saintly awards for your effort. Self-care is key. It is not selfishness. It is about maintaining your own well-being in order to be able to have the strength to fulfill the care needs of another.

Florence Nightingale, the inspiration for modern nursing, acknowledged the importance of self-care in caring for others. 

Consider keeping a journal of your successes throughout the day. Acknowledging small successes creates a positive reference point.

Setting boundaries and saying “no” when you feel you need a break is ok. That being said, make the decision to take a conscious break to exercise self-care.   It can be a way of taking control of the situation for yourself rather than letting the situation control you. Find a few minutes when you can enjoy a cup of coffee or tea glass of wine, listen to some music, read a few pages of a favorite book, do some stretches, step outside and get some fresh air even for fifteen minutes. Whatever is meaningful for you. 

Prioritize. Decide what is most important and focus on those things rather than looking at all of the things that need to be done. It may be helpful to actually write them down. An example might be to make a list of the five most important activities or tasks for the day and acknowledge when you have completed them. In this way, you can focus on what you DID do, rather than on what didn’t get done.

Most importantly, don’t listen to the critics or naysayers, even if they are family members or close friends. They are not in your shoes and do not know how you feel or what you are experiencing. It would be ideal if you could get them to pitch in. This may or may not be attainable. Either way, you are doing a great job but most importantly, in order to continue on that path, you must exercise self-care.

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