Self-Care for the Long-Term Caregiver

Ask a group of your friends to list what they believe the most stressful health care settings for employment to be and chances are that ERs, ICUs, and ORs would be immediate responses. Very likely, nursing homes wouldn't even make the short list. However, the stress of long-term caregiving can be equally, if not more stressful than working in acute care.

Long-term care is highly stressful

Think about it. In acute care settings, an emergency may arise that heightens the stress level, but then the situation resolves and care givers can recoup. Chronic care settings, such as nursing homes, may not have the frequency of emergency situations as hospitals, but instead, they have numerous occurrences of unrelieved ongoing stress, such as residents with Alzheimer's disease who regularly display inappropriate behaviors. The chronic stresses of caring for residents combined with short-staffing, family complaints, and a negative view by the general public can send stress levels through the roof!

Build on good health practices

If you are among those special individuals who work in long-term care settings, you need to pay attention to taking care of yourself. Self-care is essential to you being an effective caregiver and providing a high quality of services. Further, as a health care professional, your self-care practices can provide a positive example to others.

The primary aspect to your self-care is the practice of good basic health care practices. You may think that this is unnecessary to say this to a health care professional, somewhat like preaching to the choir, however, look at your coworkers and consider how many:

• eat poorly or carry excess weight

• fail to exercise regularly

• shortchange rest and sleep requirements

• smoke cigarettes, drink excessive amounts of caffeinated beverages

• abuse drugs or alcohol

A healthy diet, weight control, avoidance of harmful substances, exercise, regular check-ups, and adequate rest enhance the ability to cope with the stresses of caregiving...in addition to having multiple health benefits. Your step in the direction of improving your health habits may need to begin by exploring the reasons you don't practice good habits now. Chances are, it isn't not knowing what you need to do, but rather, not doing what you know you should do. Among the factors that could stand in your way are:

• the perception that you don't have the time to engage in good health practices. It is quicker to grab fried chicken at the local carry-out than to prepare a nutritious meal. Where would you ever find the time to build a half-hour walk into your day?

• low motivation. You may not be experiencing currently health problems and your significant other may not be complaining about the extra weight that you're carrying. Why trade the easy chair for exercise or junk food for carrots when you seem to be getting by just fine?

• lack of support. The same loved ones who claim that they would lay down their lives for you may not be willing to accept the healthier meals that you put on the dinner table, run the load of laundry so that you can take a nap, or accompany you on a daily walk. Perform an honest self-assessment to identify the factors that stand in the way of you following good health practices and develop strategies to change these factors.

Get in touch with your values

Conflicts between your personal values and attitudes and those of your employer can create considerable stress. These conflicts can be so subtle that you may be unaware that they exist and, therefore, are unaware of the toll they are taking on you.

Clarifying values and attitudes is essential to helping you develop a balanced lifestyle. This begins by asking yourself questions such as:

• What values do I prize and are those values honored in my work?

• What contributions do I want to make to the people for whom I care and how often do I feel I am able to make those contributions?

• What, if any, compromises do I feel I am making in my work and how does this make me feel?

• What are the five most important activities that bring me pleasure and when was the last time I engaged in them?

Recognizing conflicts in values and attitudes is the first step in learning to cope with them. You may discover that you can recommend changes that bring workplace values more in line with your own. For example, if you strongly believe that it is in the best interest of a dying resident to have one-to-one attention rather than spend the last minutes of life alone, you could discuss this with staff and propose that when such a situation occurs, they will agree to assume responsibility for a nursing assistant's caseload so that she can give extra attention to the dying resident.

In some circumstances, your employer's values may be in serious conflict with yours and you may be unable to change them. When this occurs, finding a more suitable place of employment could be an asset to your health.

Adopt stress relief measures

There are a variety of stress reduction measures that you can incorporate into your daily routines to promote health and well-being. These include progressive relaxation exercises, prayer, meditation, yoga, and the use of aromatherapy. Watching comedies, sharing jokes, and finding humor among the trials and tribulations of daily life are among the ways that you can benefit from the therapeutic value of laughter.

Separate friends from foes

Nurturing relationships are the sunlight that assist you in blossoming, while stress-producing relationships can destroy the roots that ground you. Examine the people with whom you have regular contact and their effects on you. Do they lift your spirits, energize you, make you laugh, listen to you, and spur you on to new heights? Or, do they dump additional problems on you, take more than they give, and weaken your confidence? Whenever possible, steer away from those individuals who are chronic complainers, pessimists, and critics. If these are people you can't avoid, confront them with their behavior, discuss the impact it has on you, and ask them to change. Develop relationships with people who can be more nurturing.

Be selfish

If you're like most health care professionals, you entered this line of work because of your desire to help others. This is wonderful motivation, but it sometimes gets misinterpreted as meaning that you must do for others at the expense of taking care of yourself. Overwork and over involvement lead to burnout...a no-win situation for care givers and the persons whom they serve. To remain healthy and effective, you need to develop healthy selfishness: learn to say no, set limits, and take care of your own needs. Last, but not least, affirm to yourself each day that you are giving your best and making a significant contribution through the important work you have chosen to do.