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# 2024-02-12 - Take Good Care by Cynthia Orange | |
I checked this book out from the library. My intent was to learn | |
about avoiding caregiver burnout. This book spends a lot of time | |
discussing codependency and psychological considerations. It | |
gives many anecdotes to illustrate concepts and situations. It | |
also gives valuable gems and tips for dealing with emotional, | |
logistical, and organizational challenges. But it's not all | |
challenges. The book also goes into detail on the rewards of | |
caregiving. I enjoyed reading that. | |
# Introduction | |
Healthy caregiving is the balanced act of reaching out to others with | |
an open heart and helping hand that connects us to the better parts | |
of ourselves as we connect to those in need and to the community that | |
surrounds them. Approached realistically--with intention, support, | |
and a good mixture of patience, humor, and flexibility--it can be a | |
time of joy and discovery and a chance to practice important life | |
skills that prove valuable in a variety of situations. Compassionate | |
caregiving is also an opportunity to engage in service work as we | |
make or deepen more honest, open, and balanced relationships. | |
As a writer, I know how easy it is to get hung up on words, labels, | |
and definitions--especially when it comes to sometimes loaded [and | |
overloaded] or complex terms like codependent or caretaker (as | |
opposed to caregiver). [Caretaker could also be a job title for | |
someone who manages a property.] | |
To get the most out of this book, I think it's important to make sure | |
we're speaking the same language, so I want to explain how the words | |
codependency and caretaker will be used in these pages. | |
To put it simply, I would describe codependency, as the word is | |
commonly used today, as the out-of-balance behavior of someone who is | |
overinvolved in another person's life. Melody Beattie is credited | |
for popularizing the term in her 1986 best-selling book Codependent | |
No More, in which she describes codependents as people who become so | |
obsessed with other people's feelings and behaviors that they--in an | |
effort to control or fix them--lose sight of their own feelings and | |
actions. | |
Caretakers often have a tendency to swoop in and take charge, take | |
over, or take control of a situation or person in an effort to fix a | |
situation or even a person--often without being asked or without even | |
realizing they're doing it. | |
I think it helps to think of caretaking as the out-of-balance and | |
"self-centered" behaviors that reflect a person's deep need to be in | |
control and be accepted. On the other hand, caregiving consists of | |
more balanced behaviors that reflect compassion and concern for | |
others. | |
# Chapter 1: A Closer Look at Caretaking | |
... it is up to each of us to figure out for ourselves if or when | |
caring for others is consuming us or feeding us. | |
This chapter is about identifying those [caretaking] behaviors when | |
they arise. | |
This process of identification is an exercise in self-awareness. | |
Understanding what makes us tick and why we do what we do... is an | |
important step in accepting [or assuming] responsibility for our | |
actions. Owning our actions and reactions helps us decide which ones | |
warrant attention--which ones we may want to try to change, curb, | |
limit, or forgive. | |
As I have said, it is often necessary for those who care for someone | |
who is seriously ill or disabled to become more caretaker than | |
caregiver, and we'll talk more about those particular situations in | |
later chapters. But I think anyone who lends a helping hand can | |
benefit from gaining a better understanding of their own motives, | |
actions, and reactions when it comes to giving care. More | |
importantly, I think it is extremely helpful for all of us to know | |
our individual limitations--when caring for someone is swallowing us | |
up to the point where we are risking our own health and well-being. | |
Caretakers often live in an "If I can do or say this, then this will | |
happen" world of expectation, which more often than not results in | |
disappointment and even anger. As they say in Twelve Step circles, | |
an expectation is a premeditated resentment. | |
Healthy caregiving isn't about letting go of all expectations; it's | |
about sorting out reasonable expectations from unreasonable ones. | |
Unmet expectations can leave us feeling disappointed and unhappy. | |
Now when I feel disappointment... it's usually a clue that my | |
expectations might be unrealistic and out of alignment with the | |
present reality. It's also a clue that I may be caretaking. | |
Beattie and a host of other experts who have written about | |
codependency and caretaking often talk about a caretaker's tendency | |
to "rescue" instead of being truly helpful. Some experts use the | |
more therapeutic term, describing this habit as "enabling" because it | |
encourages or allows (enables) the care receiver to remain stuck or | |
become helpless and even more dependent on the caretaker. | |
Too often, caretakers live in an "assumptive" world--they assume they | |
know best; they assume they know if someone is in need of help | |
without checking it out or asking if help is wanted; they assume they | |
know how someone feels, how they will act, or react. | |
No matter how old or how set in our ways we may think we are, there | |
is always room for change and growth. | |
# Chapter 2: Family and Cultural Messages and Expectations About | |
# Caregiving | |
For many of us, the messages we've gotten over the years about | |
caregiving and kindness have been mixed, delivered in a "do as I say, | |
not as I do" way that left us doubting the sincerity of the messenger | |
or the value of the lesson. | |
However we define family, each one has its own dynamics--their unique | |
patterns of relating to each other. | |
Our definition of family can change as our circumstances change. | |
Part of rebuilding our lives when significant changes occur is | |
deciding whom we want to embrace as family. | |
Caregiving in today's world differs dramatically from the caretaking | |
in years past. For one thing we're living longer and moving more. | |
Women's roles changed dramatically. | |
Although the times have indeed changed, many expectations have not... | |
... many studies have shown that nonwhite caregivers consider | |
caregiving to be less burdensome than white caregivers do, despite | |
the fact that the nonwhite caregiver typically has less income, | |
provides greater amounts of care, and uses fewer professional | |
services. | |
While interdependence and support are common in many communities of | |
color, Western Europeans and white ethnic groups appear to place a | |
high value on independence and self-reliance, sometimes making it | |
more stressful to give and accept care. | |
Studies also reveal that differences and challenges exist for | |
caregivers in rural areas. | |
Many LGBT adults also experience caregiving challenges in their older | |
years. ... many of the supports in place for the aging in America do | |
not cater to the special needs of LGBT seniors. | |
Since so many expectations naturally exist in the families and | |
cultures we are born into, I want to spend the rest of this chapter | |
exploring how to deal with the resulting unreasonable expectations | |
that we carry into our lives as independent adults and what to do | |
with the resentments that often follow. | |
The first step in letting go of unreasonable expectations is learning | |
how to detect the ones that could lead to disappointment or | |
resentment. | |
Whether I think or say them, I find that words like "always," or | |
"never," or "if only," or all the variants of "should," like "must" | |
or "ought to" or "supposed to," are clues that I'm on my way to | |
forming an unreasonable expectation. | |
According to many behavioral psychologists, another way to sort out | |
which expectations are realistic and which aren't is to ask if the | |
expectation is helpful or serves us in some way. Unreasonable | |
expectations are usually pretty rigid. While we might not be | |
successful in letting go of them entirely, perhaps we can be more | |
flexible and reframe them or let go of a piece of them. | |
How do you think it would feel to be more curious and open yourself | |
to possibilities instead of having preconceived notions of what | |
should or should not be? | |
In Latin, the word resent means "to feel again." Resentment is | |
unresolved anger that can slow our progress from caretaker to | |
caregiver. | |
One way to get resentments out of our heads is to write them down. | |
Those in Twelve Step groups would call this doing an "inventory," an | |
exercise that can benefit everyone--not just those in recovery from | |
addiction. | |
Anger is a normal, often useful emotion that can motivate us to make | |
necessary changes. It's holding onto anger until it turns into | |
resentment that can make us miserable. | |
When we do a resentment inventory, we write down a list of people we | |
resent and describe what happened and how we feel about it. Then it | |
is useful to write down how holding onto the resentment is harming | |
us. Is it keeping us from trusting? Is it causing rage or sadness | |
or depression? Is it affecting our self-esteem, our ambition, or our | |
other relationships? | |
The last step in this process is to brainstorm ways we might lessen | |
or let go of each resentment. | |
Someone wrote that forgiveness is giving up the idea that we could | |
have had a different past. When we lessen the grip we have on | |
resentment--and the stranglehold it has on us--we pave the way to the | |
sort of forgiveness that frees us to live life more fully in the | |
present moment. | |
# Chapter 3: Balance and Boundaries | |
The way we relate to others has a lot to do with the kinds of | |
boundaries we establish and maintain with them. A boundary is an | |
invisible line that separates what we are responsible for from what | |
they are responsible for. Appropriate boundaries can protect and | |
preserve our individuality and help keep our self-esteem intact. | |
Unfortunately boundaries are often the first things to go when it | |
comes to giving or receiving care. | |
Salvador Minuchin, a pioneer in the field of structural family | |
therapy, was one of the first to describe a family with no boundaries | |
or blurred boundaries as an "enmeshed" family system. He called | |
families with rigid boundaries "disengaged." | |
Minuchin wrote that we travel on a continuum from disengagement to | |
enmeshment that looks like this: | |
=== disengaged ---/--- clear boundaries - - -/- - - enmeshed ... | |
Simply put, when we set boundaries, we set limits. | |
Physical boundaries have to do with personal space, privacy, and | |
bodies. Unless we are pulling someone out of harm's way or rescuing | |
their belongings from a fire, we don't have the right to touch other | |
people or their things without their permission, just as they don't | |
have the right to touch us or our things without our permission. | |
Those who practice good boundary setting don't assume someone--adult | |
or child--is comfortable hugging, for example. | |
Another way to honor someone's physical boundaries is to respect | |
their privacy by not dropping by unexpectedly at their home, their | |
workplace, or their hospital room without contacting them or their | |
caregiver first. | |
Emotional boundaries separate our emotions (and responsibility for | |
them) from another person's. When we maintain appropriate emotional | |
boundaries, we learn to put the brakes on before we offer advice, | |
blame someone for our actions or reactions, or accept the blame for | |
their actions or reactions. | |
When we practice good emotional boundaries, we get more in tune with | |
which interactions are helpful and which might be hurtful. We can | |
step back and accept the feelings of others without thinking we need | |
to fix them or solve their problems. And we get better at accepting | |
our own feelings without thinking something is wrong with us that | |
needs to be fixed. | |
We also get better at knowing when and whether intimacy is | |
appropriate--when it's OK to confide or share personal feelings or | |
expressions and when or whether it feels appropriate for someone else | |
to be sharing theirs with us. | |
## Could You Just Listen? | |
> When I ask you to listen to me, and you start giving me advice, you | |
> have not done what I asked. | |
> | |
> When I ask you to listen to me, and you begin to tell me why I | |
> shouldn't feel that way, I feel like you are ignoring my feelings. | |
> | |
> When I ask you to listen to me, and you feel you have to do | |
> something to solve my problem, I often get more confused, strange | |
> as that may seem. | |
> | |
> All I ask is that you listen, not talk or do--just hear me. | |
> | |
> When you accept as a simple fact that I do feel what I feel, no | |
> matter how irrational, then I can quit trying to convince you and | |
> can get about the business of understanding what's behind this | |
> feeling. | |
> | |
> So, please listen and just hear me. | |
> | |
> And if you want to talk, wait a minute for your turn--and I'll | |
> listen to you. | |
> | |
> -- Author Unknown | |
Mental boundaries have to do with how we and others see the | |
world--how we think about things like politics, the environment, | |
career choices, child rearing, education, family, friendships, and | |
caregiving. ... caregivers ... try not to interfere with someone's | |
plan of action, whether that plan has to do with health concerns or | |
home improvements--even though they may strongly disagree. | |
When we practice healthy spiritual boundaries, we accept that there | |
are many paths to a source of higher being or purpose. When we are | |
being our best caregiver selves... we realize it is not our job to | |
foist our beliefs on them or challenge theirs, any more than we would | |
want them to force theirs on us. | |
Setting boundaries is about acknowledging limits, not building walls. | |
The goal is to gain enough sense of self and of others that we can | |
get comfortably close to other people without disappearing in their | |
shadows or taking over their lives. | |
To begin with, it is important to try to set boundaries when the air | |
is calm and clear--when we aren't tired, angry, hurt, resentful, or | |
in the midst of a crisis. | |
Determining how great or immediate a need is can help us decide if or | |
how much help is called for and how much we are willing to invest in | |
helping. Is this a onetime favor? Will this person require ongoing | |
care on a daily, weekly, or monthly basis? Are there others who will | |
also be involved in helping this person? Unless it is a true | |
emergency, taking time to objectively evaluate a situation before | |
rushing forward to offer our help is an important step in boundary | |
setting. | |
At those times when we have the luxury of choosing to offer a helping | |
hand... it's important that we do so with intention and | |
self-awareness. Here again, it helps to pause and take time to do | |
some honest self-reflection before volunteering our time and services. | |
If your desire to help has more to do with your needs than the other | |
person's, the care relationship risks getting out of balance, and | |
then boundaries can quickly get blurred. | |
Before we take on a caring responsibility--no matter how big or how | |
little--it's important to have a good idea of what other areas of our | |
lives will be affected. It is common for caregivers to overcommit to | |
others and undercommit to themselves. | |
When caregivers feel especially fragile--when they're low on energy | |
and high on emotions, feeling anxious and overwhelmed or ready to cry | |
or explode--it's a good clue they need to set or adjust a boundary. | |
# Chapter 4: The Circle of Care | |
I like Foer's comparison of caring to a muscle that gets stronger | |
with exercise. Self-awareness, boundary keeping, and the other | |
elements of caregiving all take practice. When we exercise our | |
caring muscles, we're also practicing how to connect to others in | |
healthier and more fulfilling ways. This circle of connection can | |
expand and strengthen relationships and build a community that we | |
might want to call on when we need care ourselves. | |
Finding our appropriate place in someone's circle (or net) of care | |
and figuring out whom we would want in our own circle when we might | |
need a helping hand is another way to establish and negotiate | |
boundaries. | |
One way to do this is to use what psychologist Susan Silk calls the | |
Ring Theory. Although the idea of using concentric circles to | |
illustrate degrees of connection is not a new idea or unique to | |
caregiving, I like how Silk explains hers. | |
## Circle of Care | |
0 - Care receiver | |
1 - Primary caregivers (those closest) | |
2 - Close friends and family | |
3 - Significant helpers | |
4 - Neighbors, colleagues, club members | |
5 - Acquaintances, Internet support groups | |
6 - Others, community volunteers, social media | |
Silk and Goldman say that when you are talking to a person in a ring | |
smaller than yours (someone closer to the center), the goal is to | |
help. | |
> Listening is often more helpful than talking. But if you're going | |
> to open your mouth, ask yourself if what you are about to say is | |
> likely to provide comfort and support. If it isn't, don't say it. | |
As Silk and Goldman put it, "Comfort in, dump out." | |
It takes practice and patience to become a "listening presence," but | |
it is one of the most valuable skills a caregiver can have. If we | |
learn to listen attentively, we often tune in to what people really | |
need and want to talk about. | |
Attentive listening is a way to let someone know we think what they | |
are saying is important enough to warrant our complete attention... | |
Active listening is a skill that comes in handy any time, but it is | |
especially useful in caregiving situations. | |
Tips: | |
* When someone seems to have something they need to talk about, try | |
giving them your full attention by focusing on them and what they | |
are saying. Turn off the television, the radio, and your computer, | |
and turn toward the speaker so you can observe their body language. | |
Be honest about your time. If you are in the middle of something | |
that cannot be interrupted, apologize and schedule a time when you | |
can give them your full attention and focus. | |
* Listening isn't only done with the ears; our body language, | |
posture, and even level of attentiveness all say something about | |
our interest and concern. Show you are listening by asking for | |
clarification when needed, by making eye contact, and by adding an | |
occasional "uh huh" or "I see," or by nodding your head. | |
* Show that you understand by occasionally restating (paraphrasing) | |
what the other person has said by asking things like "Are you | |
saying such and such or saying, "What I heard you say is..." | |
* Try to listen without judgment and resist the urge to interject | |
your opinion. Be aware of your personal triggers or | |
filters--things that, because of your own experiences or history, | |
might cause you to react with horror, anger, or fear. | |
If a powerful emotion arises that distracts you momentarily, it's | |
okay to apologize by saying something like "I'm sorry. That part | |
of your story struck an emotional chord for me that took me away | |
for a second. Could you repeat your last sentence? I really want | |
to hear what you have to say." Be honest if you need a break by | |
saying something like "I'm really glad you're telling me about your | |
experience, but this is hard for both of us [or for me too], and | |
I'm feeling a bit overwhelmed. Could we do this again tomorrow?" | |
* Resist saying, "I know how you feel." | |
* Make room for silence, and give the speaker time to gather their | |
thoughts. It's fine to ask if they're done speaking before you | |
respond. | |
* Resist the temptation to give advice. | |
* Validate the speaker's feelings by saying something like "That must | |
have been difficult," or "That sounds really frightening." | |
* Finally, it's important to know when to back off. Pay attention to | |
their body language as well as their words. If they seem agitated | |
or emotionally overwhelmed, check in with them by asking how | |
they're doing or if they want to take a break. | |
The overall point of this discussion is for caregivers to remember | |
that when someone is in need of care, THEY get to occupy the center | |
circle. What's going on is about them, not us... Like most things | |
that have to do with caregiving, these aren't rigid rules. Much of | |
the art of caregiving is about paying close attention to the cues a | |
care receive gives. As we flex our caregiving muscles, we get more | |
adept at reading these cues. | |
When it comes to giving care, two of the toughest questions people in | |
need of help or support often get are "How can I help?" or "Is there | |
anything I can do?" | |
A list can break down something big like "I NEED HELP" into | |
manageable parts by identifying what we might need, what we are able | |
to do ourselves, and what we might need help doing. Making such a | |
list before a crisis hits can save time, headaches, and even | |
heartache because we have tasks, names of people, and numbers at our | |
fingertips when they're needed. | |
I encourage you to make your own list. For example, list whom would | |
you most likely call: | |
* to fix your washer, dryer, or some other appliance | |
* for an electrical problem | |
* for automobile maintenance, repair, or advice | |
* for lawn maintenance | |
* to help with a house project | |
* for a computer or Internet problem | |
* for telephone repair | |
This list doesn't have to pertain to house or car maintenance. For | |
example, you may want to list the person or people you would call: | |
* in a health care emergency | |
* for financial or legal help | |
* to discuss a personal problem | |
* for emergency child care if you have young children | |
* for spiritual comfort or advice | |
* for a ride if your car broke down | |
* if you had an accident (e.g. insurance company, auto club, friend, | |
or family member) | |
* for meals if you were injured or ill or overwhelmed with caregiving | |
duties | |
* for a movie, a walk, a night out, or other fun activity | |
* to sit with a loved one if you were the primary caregiver and | |
needed a break | |
* to pet-sit if you are suddenly called out of town | |
* for a long talk or a good laugh | |
What would you add to this list? Whom would you add? When you | |
brainstorm your list, be sure to add names, emails, and phone | |
numbers, and try to update the list and the contact info when things | |
change, including backup names and numbers whenever you think of | |
them. Your list could even include things like the exact location of | |
the circuit breaker, gas and water shut-offs, modem, tools, and other | |
details that would make it easier for a person to help without having | |
to ask fifty questions. | |
Once you've completed your list of the people you might call for help | |
when you might need it and filled in your own circle of care, think | |
again about what kind of things--emotional support, task-oriented | |
help, and so on--you see yourself giving to others. | |
We discover that, as caregivers, we are a part of a vast network of | |
kindness and caring. | |
# Chapter 5: Cultivating Compassion | |
To paraphrase research professor and best-selling author Brené Brown, | |
better boundaries make room for more compassion. Compassion is at | |
the heart of caregiving and comes from a Latin word that means "to | |
suffer with." To me, compassion is a generous word that describes a | |
quality that allows people to tend to the needs of another while | |
suspending their need to control, fix, or manipulate. | |
The word empathy comes from a Greek word that means "in feeling" or | |
"feeling into." | |
To me, being "in feeling" means feeling with someone. | |
... I could not genuinely care for and support my husband if I was | |
not taking good care of myself. | |
In an article titled "What Is Empathy?" experts at the University of | |
California Berkeley's Greater Good Science Center explain the | |
difference between "affective empathy" (sometimes called "emotional | |
empathy") and "cognitive empathy." According to them, affective | |
empathy relates to the feelings we have in reaction to other people's | |
emotions. They write that "this can include mirroring what that | |
person is feeling, or just feeling stressed when we detect another's | |
fear or anxiety." They state that cognitive empathy, which is | |
sometimes called "perspective taking," is about our ability to | |
identify and understand people's emotions. | |
But I also believe that even if we do have the capacity to empathize, | |
t also takes self-awareness and practice to fine-tune our empathetic | |
natures--especially when it comes to caregiving. In fact, doing | |
favors, volunteering, caring for and about others, and just plain | |
being kind are all ways to practice empathy and strengthen our | |
ability to empathize. | |
Recent studies also show how our own emotions can affect our capacity | |
to empathize with another person. ... This is a good reason for | |
caregivers to check in with themselves to make sure they are able to | |
be truly present with someone who is in need of a shoulder or a | |
listening ear. This checking-in process is often called "emptying | |
your cup." | |
The idea of emptying your cup is often linked to the Buddhist story | |
about the Zen master and the scholar who came to the great teacher | |
full of enthusiasm and ideas, eager to impress him with all that he | |
had learned about Zen already--all the places he had studied and the | |
knowledge he had gained along the way. As he rambled, the master | |
poured tea into the student's cup. As he talked and talked, the | |
master poured and poured, until the student shouted in alarm, "Stop! | |
The cup is already full!" To which the master replied, "You are like | |
this cup. You come to learn, but make no room for anything else | |
because your cup is already too full. Before you can hear, before | |
you can learn, you must empty your cup." | |
I consider emptying our cups an important element of caregiving. | |
We can practice empathy by emptying our own cup, slowing down, and | |
paying close attention to what someone is saying and how they are | |
saying it. Being mindful in this way can help lessen the | |
distractions that might interfere with our ability to be fully | |
present with another person. We can talk less and listen more, | |
trying our best to suspend judgment, not rushing to conclusions or | |
diminishing someone's experience by treating it too lightly. We can | |
try our best not to offer pat advice or empty consolations like "at | |
least you're alive..." | |
While empathy is feeling and being with, I view compassion as the | |
next step--the reaching out and doing. | |
As I understand it, compassion encompasses empathy but can include | |
doing as well as being. In other words, we can be empathetic and | |
compassionate at the same time. | |
Unlike pity, which usually describes a "one up/one down" response | |
(e.g. "I feel so bad for the starving children in Ethiopia"), to me | |
an expression of sympathy is an acknowledgment that you realize that | |
someone is going through a difficult time. | |
# Chapter 6: Joys, Challenges, and the Importance of Caring For | |
# Ourselves as We Care For Others | |
The paradox of choosing to practice what I describe as "empathetic | |
compassion" in the preceding chapter is that such an act has the | |
potential to fill you up both emotionally and physically or suck you | |
dry. | |
It's true that without safeguards or appropriate assistance in place, | |
caring for others can take a serious toll. Yet recent studies show | |
that--generally speaking--helping others has numerous benefits. | |
To me, caregiving: | |
* is an opportunity to practice empathy and compassion | |
* is a chance to redefine, improve, and evolve relationships, making | |
them more honest, open, and deeper | |
* is an opportunity to exercise and rediscover the better parts of | |
ourselves | |
* is a chance to practice flexibility | |
* offers the freedom to change lifestyles, perceptions, expectations, | |
judgments, etc. | |
* is an opportunity to practice life skills like living sanely and | |
serenely | |
* is an opportunity to give back | |
* is a chance to practice and appreciate the present moment | |
* is a way to get us "out of our own heads"--lessening worry and | |
depression | |
* if we're in a Twelve Step program, is a chance to practice the 12th | |
step--the "service step" | |
* is a chance to develop new and more intimate connections | |
* provides a chance to improve communication skills | |
* offers the opportunity to expand or discover community (e.g. mutual | |
caregivers, others in the same situation, the community surrounding | |
the person for whom we are helping) | |
* is a chance to practice reaching out, asking for, and accepting help | |
* is a possible time of rediscovery/recovery/reconnection | |
* is an opportunity to practice "delegation" skills | |
* is an opportunity to use teachable moments with kids | |
* can help us hone or lean practical skills (e.g. cooking, home | |
repair, navigating a computer or smartphone) | |
* is a way to put our values in action | |
* is a way to expand our own caring circle for times when we might | |
need help | |
* is an opportunity to connect with and learn from individuals of | |
different ages, ethnicities, cultures, beliefs, and experiences | |
If caring responses to ordinary life events can get to a point where | |
we are affected both emotionally and physically, imagine the toll | |
that caring for someone with a serious or ongoing care need can take | |
on a primary caregiver. While healthy and balanced caregiving can | |
lengthen our lives and improve our health, primary caregivers in | |
difficult and challenging circumstances face serious threats to their | |
health and well-being. Research shows that overwhelmed caregivers | |
have a greater chance of dying sooner than their non-caregiving peers. | |
Caregivers who experience a number of the following signs and | |
symptoms risk stress overload: | |
## Cognitive Symptoms | |
* memory problems | |
* inability to concentrate | |
* poor judgment | |
* seeing only the negative | |
* anxiety or racing thoughts | |
* constant worrying | |
## Emotional Symptoms | |
* Moodiness | |
* Irritability or short temper | |
* Agitation or inability to relax | |
* Feeling overwhelmed | |
* Sense of loneliness or isolation | |
* General unhappiness | |
## Physical Symptoms | |
* Aches and pains | |
* Diarrhea or constipation | |
* Nausea, dizziness | |
* Chest pain, rapid heartbeat | |
* Frequent colds | |
## Behavioral Symptoms | |
* Eating too much or too little | |
* Sleeping too much or too little | |
* Isolating yourself from others | |
* Using alcohol, cigarettes, or drugs to relax | |
* Nervous habits like nail biting | |
The longer we ignore stress symptoms, the more serious they can | |
become. If you are consistently experiencing a number of the above | |
symptoms, it might be a good idea to consult a qualified medical | |
professional... As we'll see, asking for and accepting help is an | |
important element of self-care. | |
I believe that self-compassion begets self-care. Kristin Neff, a | |
psychology professor and well-known expert on the subject, describes | |
self-compassion as "giving ourselves the same kindness and care we'd | |
give a good friend." | |
Neff stresses that self-compassion is NOT the same as self-esteem, | |
which is about our feelings of self-worth. | |
If you made a list of all the things you intend to do today, would | |
anything having to do with self-care be on it? | |
Sometimes the process [of asking for help] is easier if we can break | |
it down. First, it helps to be clear about the need or problem. | |
Next, it helps to identify who can most appropriately give you the | |
help you need. The last step is to actually ask for the help you | |
need. It helps to be as clear and specific in your request as you | |
can be and, if possible, estimate the amount of time you think such a | |
favor may require. If someone is unable to help you, try your best | |
to accept their answer at face value. Thank that person and ask | |
[someone else] or ask if they have an idea of whom else you might | |
contact. | |
Without healthy boundaries and good self-care, overburdened | |
caregivers are at risk for compassion fatigue, which is just what it | |
sounds like. | |
# Chapter 7: Preparing For The Unexpected | |
... the longer we live, the more curve balls life seems to throw us. | |
When caregiving chooses us, it's more important than ever to have our | |
"caring house" in order, to have our list of resources as well as our | |
circle of care in place, to sharpen our empathy and listening skills | |
when we can, and to regularly practice the elements of self-care | |
we've discussed... | |
Caring tools are like car or home emergency kits. | |
## In Case of Emergency (ICE) Card | |
Medical emergency info for: | |
[Name, Address, Home number, Cell number] | |
Emergency contacts: | |
[Names, Relationships, Home numbers, Cell numbers] | |
Insurance information: | |
[Company, Phone number, Note that says "cards in wallet"] | |
Primary physician: | |
[Name, Phone number] | |
Medical conditions: | |
[Ongoing medical problems] | |
Blood type: | |
Allergies: | |
Medications: | |
[Share cards with each other. Primary caregivers may carry a copy of | |
the care receiver's card.] | |
Keeping track of medications, appointments, and bills, as well as | |
wading through tons of information about test results, diagnoses, | |
treatment plans, surgery options and dates, and the like can be an | |
exhausting and overwhelming aspect of caregiving. | |
Suggestion: | |
Get a 3-ring binder for note taking, gathering questions for various | |
providers, and keeping a lit of test results over time... Use tabs. | |
Include a section for Thank Yous. Include a separate section for | |
things that bring the care receiver pleasure or joy. | |
Scan information and put it on a flash drive including living will, | |
provider order of life sustaining treatment, meds list and doses, | |
copy of driver's license, copy of front and back of medical insurance | |
card, insurance claim numbers, list of all doctors and their contact | |
information. Make sub-folders for email correspondence. Include a | |
password file. | |
Useful sites: | |
MealTrain - organize meals for someone who needs them | |
CaringBridge - share health updates with family and friends | |
I think one of the most dramatic relationship balancing acts takes | |
place when adult children become caregivers for their parents or | |
other older adults. It can get complex and confusing when we find | |
ourselves in a situation where someone who took care of us for a good | |
portion of our lives now has to rely on us to help them with so many | |
aspects of their own lives. | |
This can get a little awkward when we, as adults, end up assisting a | |
parent or other older adult with personal things like dressing, | |
bathing, or going to the bathroom. Things like helping them manage | |
their finances, having uncomfortable conversations about medical | |
issues, or expressing our concerns about their ability to drive or | |
live independently can be difficult as well. | |
... lots of caregivers benefit from the support they receive in a | |
caregivers' group. ... If you cannot find a caregiver group in your | |
area, check the Internet for online support groups. | |
# Chapter 8: The Special Challenges of Brain Disorders and Dealing With | |
# Anticipatory Loss | |
While dementia is classified as a group of symptoms that can affect | |
our memory or ability to reason, Alzheimer's is classified as a | |
progressive disease that can cause dementia. | |
I also learned from the time I spent with my memory-impaired friend | |
how absolutely critical it is to also support and help the primary | |
caregiver in these types of situations. They are often exhausted and | |
overwhelmed trying to keep it all (and themselves) together as they | |
try to adjust to this new reality while grieving the way things used | |
to be. | |
Caregivers--both primary and secondary--often struggle with how to | |
best navigate this new way of being with the least amount of | |
frustration and the greatest amount of respect. I think of it as | |
being lost in the "bewilderness." | |
# Resources | |
Family Caregiver Alliance (FCA) | |
1-800-445-8106 | |
In addition to an extensive library of fact sheets, articles, | |
checklists, webinars, and videos on caregiving issues, FCA offers a | |
state-by-state Family Care Navigator at its website to help family | |
caregivers locate public, nonprofit, and private programs and | |
services nearest their loved one--living at home or in a residential | |
facility. Resources include government health and disability | |
programs, legal resources, disease-specific organizations, and more. | |
Caregiver Action Network | |
Caregiver Action Network provides education, peer support, accessible | |
tools, and resources to assist caregivers in managing the care of | |
their loved ones. | |
National Alliance for Caregiving (NAC) | |
NAC is a nonprofit coalition of national organizations that focus on | |
advancing family caregiving through research, innovation, and | |
advocacy. It develops national best-practice programs and works to | |
increase public awareness of family caregiving issues. | |
Rosalynn Carter Institute for Caregiving | |
The overall goal of the Rosalynn Carter Institute for Caregiving is | |
to support caregivers--both family and professional--through efforts | |
of advocacy, education, research, and service. | |
AARP is a nonprofit, nonpartisan organization with a membership of | |
nearly 38 million that deals with issues that matter most to | |
families--such as health care, employment, and income security, and | |
protection from financial abuse. AARP's Caregiving Resource Center | |
offers up-to-date, expert advice and resources on caregiving issues | |
and concerns. | |
U.S.Administration on Aging Eldercare Locator | |
This is an easy-to-use, free public service that can connect | |
caregivers to services for older adults and their families in their | |
area. Caregivers simply put in their zip code and select the kind of | |
services they are looking for on the drop-down menu. You can also | |
call 1-800-677-1116 | |
Medicare Caregiver Resource Kit | |
This section of the "Ask Medicare" tool kit offers informational | |
resources that can be printed directly from the website and provided | |
to caregivers. The resources are designed to help caregivers address | |
challenging issues and work effectively with Medicare to ensure their | |
family members and friends receive the best possible care. | |
Alzheimer's Association | |
Formed in 1980, the Alzheimer's Association is the world's leading | |
voluntary health organization in Alzheimer's care, support, and | |
research. It provides an easy-to-use interactive map to help | |
caregivers find support and services in their area. It also provides | |
a 24/7 help line phone number as 1-800-272-3900 | |
Interactive Map | |
U.S. Department of Health and Human Services Caregiver Resources | |
Caregivers can find links to a vast amount of information regarding | |
caregiver resources and information on long-term care at this | |
website. | |
author: Orange, Cynthia | |
detail: https://hazelden.org/store/item/400137?Take-Good-Care | |
LOC: RA645.3 | |
tags: book,non-fiction | |
title: Take Good Care | |
# Tags | |
book | |
non-fiction |