Strength and Hope Together . . .

I recently attended a faith community nurse workshop which focused on caring for the caregiver. That is to say, when a person is solely responsible for the care of a family member who is ill, often a healthy family member ignores his/her own self-care in order to provide the best care possible for the one who is ill. The challenges of that situation have been presented in this healthcare communication in the past. What prompted a revisit of this topic is the new book, Cruising Through Caregiving, by Jennifer L FitzPatrick, a social worker who offers support and practical ideas on the needs of an elder family member. It sounds intriguing that "cruising" was used in the title, since that implies "smooth sailing," something unrealistic to real life experiences.

The focus on the health of the caregiver can be applied to those of any age, whether providing care to infants, children, or adults; and the caregiving needs may vary in intensity and duration. 

While multi-tasking may be necessary from time to time, doing so every day or every week, depletes the overall strength of body, mind, and spirit. The effect on the body can become chronic sleep deprivation, irregular eating habits, increasing physical and mental stress, depression, and anxiety. If you note that in yourself or another family member or friend, consider reaching out to others who are concerned to get help with the care of the “patient” or the chores of the household, to provide some respite for the primary caregiver.

In no way do I intend to minimize this burden which can become exhausting. But let me note some suggestions that may be beneficial, including my offer of loaning the book Cruising through Caregiving, if you wish to read additional information.

Some guidance to consider:

  1. Be in the here and now; tend to the tasks of immediate need without those thoughts of "what about . . . [a host of other things]?" Schedule breaks for yourself in the day in order to spend even a few minutes taking a nap, reading, or visiting with a friend.

  2. Slow down; pace the tasks of the day over a reasonable time frame, allow for flexibility whenever possible.

  3. Take a deep breath. It is a tendency to become so caught up in the busy-ness that we forget the basic self-care of restorative deep breathing. Even better – practice deep breathing outdoors and/or during a leisurely walk.

  4. Unplug, as in making time for yourself, as noted above. Permit yourself the luxury of a nap or perhaps a brief outing which may energize you. One of my own memorable experiences along this line was when a friend took me to her favorite greenhouse to browse through the flowers and plants, relaxing in the moment, thinking only about the garden, for a short time.

  5. Nurture a joyful disposition. That is not to deny the difficulty of the work at hand, but look for times during the day that are worthy of gratitude. It need not be grandiose or life-changing; but there can be joy in a phone call from a friend, fresh linens out of the dryer, or a pause for a cup of tea. The attitude of gratitude can renew physical and emotional energy. It can be that "strength for today and bright hope for tomorrow" from God's faithfulness.

The Role of Caregiver

This title really ought to read plural, the ROLES of a caregiver, because there are many tasks and responsibilities that go with care-giving, and about the time it seems the condition(s) has changed, it evolves yet again. This narrative will attempt to offer general, broadly-applied concepts that fit many clinical and personal situations. For more individual clinical detail, feel free to contact nurse@goodshepherdmpls.org.

It is very common that the role of caregiving becomes an on-going series of tasks, from providing transportation for medical appointments, to round-the-clock assistance with mobility and/or management of physical care, to keeping up a household including meals, laundry, maintenance of home and yard. Acting as caregiver is physically and emotionally demanding which increases physical and emotional stress for both the caregiver and the patient. In order to strengthen and support the caregiver, this information will address the stress of the caregiving role. Typically as caregiver there is the responsibility for finances, even for someone who has never taken that responsibility before now. There is often a change in family relationships when one fully depends on the other.

Often a family member willingly and cheerfully takes on the role of caregiving out of pure love and good intentions. Do not forget how it was at the onset of illness. But over time, the caregiver suffers serious stress which may manifest as headaches, body aches, chronic fatigue, ‘forgetting’ to eat, i.e. putting the sick person first under all circumstances. The long-term effects of this sort of physical and emotional stress might include anxiety and depression, a weakened immune system, weight gain or loss, indigestion, difficulty in paying attention to concerns outside of the caregiver role.

Without being too simplistic, it’s important to maintain your own health if you are caring for another family member. Therefore, see your own physician when you have some signs of caregiver stress.

Describe your home situation, perhaps there are medications to help you, for instance, if your blood pressure is out of range; or perhaps your doctor can suggest some home health care to give you some respite yourself, thereby relieving some of your own stress.

Tension, frustration, exhaustion may become manageable in a few common ordinary ways.

  • Complete a small task, to give yourself a feeling of accomplishment, i.e. even as simple as folding clothes.

  • Eat right, including protein, fruits, vegetables.

  • Get enough sleep; nap when possible.

  • Set aside time each day for prayer and meditation.

  • Get and use a coloring book yourself --- really!

  • Keep a daily journal.

  • Schedule time with friends or family to come to visit you, as well as your family member who is ill.

  • Consider getting a pet; if you have one, keep it close.

  • Ask for, and accept help. Keep a to-do list handy for someone who wishes to be helpful for you. Or perhaps, as someone pointed out, ask the person who offers to help stay with your loved one so YOU can tend to the to-do list. It can be a therapeutic stress reliever to rake the yard or sweep the garage. Being open to accepting help when it is offered is sometimes hard to do. Do not feel guilty for taking care of yourself because self-care enables you to keep your loved one at home.

WHEN COUGH DROPS ARE NOT ENOUGH . . . . .

A chill is in the air – ‘tis the season for viruses and colds. These illnesses are highly contagious, as seen in the prevalence in household members and classroom populations that seem to all be sick at the same time. The spread of these conditions occurs with coughing, sneezing and most anything and everything that the ill person touches.

Before I begin sharing my personal and professional suggestions, I must clarify standard precautions. The advice shared here is intended for those individuals who do not have other chronic illnesses, who do not have allergies to any products mentioned and is only for those known to be otherwise healthy. This information is not intended to replace medical care from your usual and customary healthcare provider. Please discuss any specific medical concerns with your personal physician. Your pharmacist is also a good resource about over-the-counter remedies and whether there is contradiction between them and your other prescriptions.

Typically, colds come on gradually and disappear gradually. Typically, “the flu” has a rapid onset of symptoms, primarily respiratory symptoms of cough, head congestion, sore throat, fever, chills, aching and profound fatigue.

General Guidelines:

  • Increased rest.

  • Increased fluid intake.

  • Wash your hands with warm soapy water several times each day for treatment and prevention.

  • Monitor your temperature; stay home when oral temperature is 100.5 degrees fahrenheit or greater.

  • No aspirin for children; treat fever with alternate fever-reducing over-the-counter medication.

  • For adults, it is safe to use aspirin or fever-reducing medication of your choice.

 Power Pack Remedy Recommendations

Note: Always following dose directions on the package. Double check whether the medication is appropriate for children.

  • Emergen-C – 2-3 times/day

  • Coricidin HBP Cough and Cold – as directed on package

  • Aspirin (adults only) – 3-4 times/day, with food. Note: For children, use another fever reducer product as directed on package.

  • Mucinex (plain or DM; not D) – 600-200 mg, two times/day

  • Any cough syrup or cough drops will relieve and lessen the annoyance of persistent coughing

Rationale for The Recommendations:

  • Sudafed and other decongestants cause elevation in blood pressure. Many people experience a rebound effect from Sudafed, i.e. it makes congestion worse instead of better after two days of use.

  • Emergen-C contains vitamin C, zinc and other minerals that increase immunity.

  • Aspirin treats fevers very effectively, as well as relieves the aching.

  • Mucinex is guiafenesin. Mucinex DM is guiafenesin with dextromethorphan; it loosens mucus in sinus and chest to reduce chance of getting a secondary bacterial infection. If nasal secretions or coughing produces dark yellow or green mucus for more than a day or two, while you are running a fever, see your personal physician, or go to Urgent Care. At that point, you may need prescription medications.

Email me if you have questions: nurse@goodshepherdmpls.org

Be well!