Survival 101: Self-care for caregivers
How to cope when others need more than you can give
By Deborah Armstrong ’87

inger, who works full-time outside the home and mothers a preschooler and two teenagers, is concerned about the job-related stress her husband faces and her parents’ health.

Despite that pressure, she tries to create a warm and comfortable home but some evenings she is exhausted by bedtime. To add to her difficulties, her close friend and neighbor, who used to help with childcare, passed away last year.

Ginger is not alone in feeling the tension between others’ needs and what she can give them. Not surprisingly, professional care providers may also experience this tension. Physicians, nurses, social workers, teachers and clergy—all may develop “compassion fatigue.”

People who care for others tend to be compassionate and attuned to what others require. This trait may lead caregivers to focus too much on others’ needs and not enough on their own—increasing the possibility of burnout.

But if situations require that you be responsible for others, how do you maintain your strength for the long haul? How do you avoid running yourself into the ground?

Consider these practical ways to preserve your ability to cope in the face of multiple demands.

Set boundaries
What can you reasonably expect to accomplish in the time available? You may not be able to do all the things you want to. Prioritize by answering this question: What tasks are most important to you? Then, commit to those and firmly say “no” or “maybe later” to less important tasks.

Ginger sets her priorities by what is important to her health and her family’s health. She limits her evening commitments so that she and her husband can spend that time together after dinner, walking, talking over their day’s experiences, playing with their preschooler and helping the teenagers with their homework. As much as she used to enjoy volunteering with other women in her community, she is deferring that until her life is simpler.

Express your feelings
Most caregivers feel helpless, angry and frustrated at times, especially after a difficult experience. Talking through the experience may help you release those feelings and move forward. Do you already know someone with whom you can be honest about your feelings?

This might include a spouse, a member of the clergy, a long-time friend or a trusted colleague at work.

Rest
The concept of a sabbath in which to take pleasure in work well done is as old as the story of Creation. You may already know some basic relaxation techniques that help you rest, such as breathing more deeply, relaxing your muscles or visualizing a beautiful place.

Where do you find joy? What is fun for you? What forms of recreation absorb your attention? One woman told me, “I watch sunsets.” Others rest by making music or capturing beauty through photography or painting.

What activities help you release tension? Walking? Dancing? Swimming? Gardening? Woodworking? Fishing? Going to the gym? Notice which activities relax you most.

Honor your body’s need for restorative sleep. Research has shown that people feel better able to cope when rested. They also work more accurately and efficiently when they have had enough sleep.

Meditate
In January 2003, the American Psychological Association published a summary of 25 years of research on the value of meditation in reducing both blood pressure and stress hormone levels (Seeman, Dubin, & Seeman).

Meditation may take many forms. Ginger takes a yoga class on Saturday mornings. She has learned ways of breathing and relaxing that she uses during the week to help her feel calmer.

Meditation may also include sitting quietly, praying alone or with others or going on a retreat. To what extent have you already found meditation or prayer helpful?

Reflect on your strengths
What difficulties have you overcome in the past? What helped you deal with those challenges?

Ginger has been better able to deal with her challenges because of her strengths. She is articulate and educated. She is able to talk about her feelings, from grief to anger to pleasure to happiness. She has made and maintained several close friends over the years. As they talk over their concerns with one another, Ginger gains new insights into her own situation and new ideas on constructive ways to handle things.

Dream
What are your hopes for the future? Where do you want to be this time tomorrow? Next week? Next year? In five years? In ten? Let yourself think beyond the present difficulties. In what ways might you begin to move into the future you want to create? Ginger’s dream, when her children are grown, is to use some of her savings to travel more with her husband. In the meantime, Ginger and her family are enjoying planning a trip to the Grand Canyon next summer.

Look for a mentor
Who else has walked in your shoes and faced similar difficulties? What people do you know who have weathered a storm similar to the one you face? Ask what helped them handle the challenges as well as they did.

One of the friends who has been most helpful to Ginger is Marie, who is 15 years older. Marie’s father is now in assisted living. Ginger has felt better about her own parents’ future after learning how Marie managed that transition.

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Deborah Armstrong, Psy.D., is a licensed psychologist in private practice in Haddonfield (www.drdeboraharmstrong.com). She has presented self-care seminars to churches, schools and community groups. Counseling since 1992, she has co-authored research articles in professional journals and taught pastoral counseling at Palmer Theological Seminary. She completed her psychology internship at Princeton University Counseling Center and specializes in counseling adults.