Self-Care for Caregivers
By Michael Bergeron, MA, LMHC
Many of us, including doctors, nurses, therapists, and first responders, choose and embrace the role of caregiver. However, some caregivers, such as parents, spouses, family members, and significant others, have the role thrust upon them when someone they love experiences a serious illness or a traumatic injury, like a burn. Whether you have chosen your role or not, caregiving is a highly stressful activity that can take its toll, leaving you feeling exhausted and emotionally drained. Recognizing and responding to your own needs is as important as responding to the needs of your patient or loved one. Left unattended, you leave yourself at risk of burnout, a dangerous state for you and for those for whom you care.
TRYING TO DO IT ALL
For most of us, caregiving is multidimensional. For example, a nurse may not only respond to his or her patients’ physical need for wound care, but also to their emotional, mental, and social needs. A patient’s spouse or family member may need to not only assume all the duties of a nurse, but also to assume those household, family, or business duties previously handled by the injured person and, in most instances, to do so immediately after a traumatic event.
Suffice it to say the role of caregiver carries with it a sufficient amount of stress. How we deal with that stress determines, in large part, the quality of care we provide. However, our ability to provide quality care is also influenced by several other factors, not the least of which is how we care for ourselves.
DEALING WITH THE STRESS
All too often caregivers allow the illness or disability of others to overshadow their own needs. They may believe that it’s okay to sacrifice their own well-being because someone really needs them; they may feel as if they would be abandoning the person who needs them and therefore continue out of guilt; or they may continue to sacrifice themselves because they need to be needed in order to feel fulfilled. Unfortunately, all these methods are unhealthy for the caregiver and may, in fact, be a strong sign of codependency—or caring for others at the expense of caring for yourself.
In my experience, I have seen health professionals and family caregivers lose their effectiveness with the best of intentions. Many times they are simply overwhelmed by the nature and chronicity of their circumstances. Most often, however, they are simply unable to recognize and accept their own limitations. In such cases, the caregiver’s personal needs go unmet; other relationships are neglected; and resentment, anger and frustration begin to grow. The caregiver feels unappreciated and fatigued, and the result is a state of physical, mental, and emotional exhaustion. In short, he or she is “burned out”!
Burnout is caused by unrealistically high role expectations and impossible goals based on your personal wants and needs. Ironically, the road to burnout is paved with the best of intentions. It is certainly noble to be an idealistic, hardworking, self-motivated achiever with high expectations who cares for the needs of others. However, when your ideals are perfectionistic and you strive with single-minded intensity toward unrealistic goals, you are doomed to burn out.
LEARNING THE SIGNS OF BURNOUT
Burnout doesn’t happen over night, rather it creeps up on you in phases. At first you may embrace your job as caregiver—you have energy and enthusiasm, you believe you can handle it all, and you believe your job will bring with it all the rewards you deserve. You may also believe that the person for whom you care will be forever grateful for your efforts and your efforts will be reciprocated. After a while, however, you may realize your initial expectations were unrealistic. Perhaps your needs are not being satisfied, and reward and recognition are scarce. Disillusionment and disappointment may begin to grow, and you may actually work harder and harder attempting to make your hopes come true. Eventually you may begin to question your competence and start to lose selfconfidence. Fatigue and irritability may set in and your eating and sleeping patterns may change. You may even begin to engage in escapist behavior, like substance abuse, gambling, partying, or shopping. Your work may deteriorate, you may become indecisive and others may begin to notice and comment on your change. Depression and anxiety may set in as you fall into a state of despair. You know you are in a state of burnout when you feel an overwhelming sense of failure and loss, and your confidence and self-esteem plunge.
Keep in mind that although your “symptoms” might not be as dramatic as these, you may still be experiencing some of the feelings that can lead to burnout. It is important that you do recognize what’s happening and take steps to prevent further problems.
Striking a Balance
As the Phoenix, you can “arise from the ashes,” but be aware that it takes time. Be realistic about your job and role expectations, your aspirations and goals. It is vital that you take a personal inventory and accept your limitations. Furthermore, you must be willing to communicate with those for whom you care and with whom you work. Talk about your thoughts and feelings, goals, and aspirations. Get feedback from others whom you trust, and ask for help when you need it. Make time for yourself every day and accept the fact that you are important. Find ways to engage in self-care so that you have the energy and clarity it takes to provide care to others. And don’t be afraid to readjust your goals as necessary to balance your life with the lives of your loved ones. Then you will be able to provide quality care and still have quality of life.
SUGGESTIONS FOR SELF-CARE
Exercise on a regular basis.
Eat regularly and eat a balanced diet.
Restrict your intake of caffeine and alcohol.
Develop a consistent sleep pattern.
Develop a hobby unrelated to your work.
Embrace your spirituality.
Consider getting a pet.
Set aside time to play.
Nurture your friendships.
Make time for intimacy.
Read a book.
Take a vacation.
Get out of the city and take a ride in the country.
Get a massage.
Take a bath.
Go to bed and don’t set your alarm.
Go to a movie, buy some popcorn, and sit in the back row.
Run naked through the park—or maybe not!
Michael Bergeron was a co-presenter of the session “SelfCare for the Caregivers: Just Say No” at the 2005 World Burn Congress, where he also served as a member of the mental health team. He is a licensed mental health counselor in private practice and a consulting therapist for the St. Joseph Burn Center at St. Joseph Hospital in Ft. Wayne, Indiana. He also serves as an employee assistance plan therapist for the Lutheran Health Network in Ft. Wayne. He holds a certificate in critical incident stress management.
This story is an excerpt from The Phoenix Society’s® Burn Support News, Spring Edition 2006, Issue 2. Burn Support News is a quarterly publication that contains articles on the emotional, psychological, and social aspects of burn recovery. All Rights Reserved.
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