Taking a vacation from caregiving. Part-1

by Carol Bradley Bursack

Caregiving is, by nature, emotional. When loved ones need our care, it's generally because their health is beginning to fail. As this happens, giving care can become a full-time occupation, mentally if not physically. If we decide that we need a break from the pressures of 24/7 caregiving, we often suffer emotional separation anxiety, headed by guilt. How do we cope with our emotions well enough to actually enjoy the vacation we've chosen to take?

If there is one emotion that nearly all dedicated caregivers have in common, it's guilt. We feel guilty for not giving enough when we've given all we can; we feel guilty for not being able to make someone well, when no one can do that; we feel guilty if our loved one isn't happy all the time; we feel guilty if we do something fun for ourselves. However, if we are there - right there all of the time - we have a better chance of feeling that we are doing ""okay."" If we take a vacation, we suffer more guilt, because we know our being gone will affect our elders, and also bring on a type of separation anxiety in ourselves.

Cope with Guilty Feelings, Then Do It Anyway

Planning a vacation, and actually enjoying it, will mean coping with your own guilty feelings and coming to peace with the fact that there are others who can fill in while you are gone. Often, this means hiring in-home care agencies, if you are doing home care, or even using assisted living. Nursing homes, of course, are already staffed, so that is a matter of trusting the staff with your loved one.

Making a vacation from caregiving happen will probably take a real push on your part. You may have to make a focused effort to take this step, as your own excuses as to why you can't take time for yourself could overwhelm your desire, and need, for a break.

You may want to work through the feelings, rather than stuffing them down, because unexpressed emotions have a way of working their way out at inopportune times, say in the middle of your romantic dinner on a cruise.

Support groups are a good way to work this through, if you can get to one. If you can't get away enough for a support group meeting, the Web abounds with online forums and support sites. You can do both, for that matter. Either way, I'd suggest that you make a list of concerns you have about leaving your loved one temporarily in the hands of others. Make it as detailed as you choose, and feel free to be over the top with your worries. Then, use this list when you address your worries with a group or with a caregiving friend.

Here's a sample list:

Dad will miss me, and forget where I went. He'll feel abandoned.

Mom will tell me repeatedly that no one can understand her needs except me, and she'll feel unloved.

There will be a devastating hurricane and I won't be there to help my parents (even though they live in Ohio).

The nursing home staff that has cared for my spouse or parent for five years will suddenly become abusive if I'm not there every day.

Dad will have another stroke and die before I can return.


How to Handle Guilty Feelings

Now, take each of the unique items you listed, and tell another caregiver about it (or a therapist). Talk through each item until you've come to a place where you can separate real concerns for generalized fear of change. Then, look for solutions. We'll take the list above:

  1. Dad will miss me and forget where I went. He'll feel abandoned. Depending on Dad's cognitive ability, he may or may not miss you, as in he may or may not be cognitively aware that you are gone. If he is cognitively able to track time, he will notice you haven't been around. He may or may not remember you told him you'd be gone for several days, but he may wonder where you've been. The solution here is to make sure the caregiver in charge has an answer for him that will make sense to him if he asks for you. Also, you can leave written notes or pictures that may remind him of you. When my Dad was quarantined from visitors because of a flu epidemic in our community, I dropped off notes for dad at the nursing home each day, written in big black print he could see. The notes reminded him about the reason I wasn't there, and that I'd be back soon. That did help. You could do the same, only leave them for a caregiver to give to your loved one each day.
  2. Mom will tell me repeatedly that no one can understand her needs except me, and she'll feel unloved. Mom may be consciously controlling you here, or she may just feel so dependent she doesn't understand any needs but her own. Either way, you can reassure her that you have made arrangements for her care, and that you will soon be back. Be kind and loving, but tell her all is well. Then take your vacation. She'll get over it.
  3. There will be a devastating hurricane and I won't be there to help my parents (even though they live in Ohio). This is, of course, your caregiver guilt in overdrive. You are getting that feeling that no one can do everything you do for your loved ones the way you do, therefore you must be there to do it. I've been there. I know. Take your caregiver ego and give it a talking to. While your loved one prefers your constant presence, others can care for him or her for awhile and the world won't end.
  4. The nursing home staff that has cared for my spouse or parent for five years will suddenly become abusive if I'm not there every day. Time for a reality check. If you know the home and staff well, and you have no reason to believe that they are pulling something over on you now, their behavior is not likely to change in your absence. Besides, you can have other's look in on your loved one, just to make sure all is well.
  5. Dad will have another stroke and die before I can return. This can happen. He could also die while you are home getting some sleep. Or, you could die due to your own health issues. Make sure everything is in place, and then take your vacation. Obviously, if someone is in the process of dying, you would not go. Otherwise you can. There are never guarantees and if you wait for the perfect time, you won't ever go.

Finding Substitute Care is Primary to Relieving Guilty Emotions

None on the above steps will work unless you've got substitute care in place. In-home care is a very good answer if you are caring for someone at home. Nursing home staff is already in place if your loved one is in a home, so you can set up your schedule with them. The same goes for assisted living staff, only you may want to hire an in-home company to supplement your care at the assisted living facility. Any way you look at it, unless you have family members or friends to substitute for you, you'll need to get help, likely from an agency. Have a trial period, if new people are involved, so you can be sure everyone is on board and that they know your loved one as an individual. Then go, guilt free. You've done your best, so you have to let the rest handle itself. Refresh yourself with a break and you'll likely come back with more enthusiasm for your caregiving role.

Caregivers can get so caught up in daily tasks and obligations that they don't even notice that the ongoing stress of caregiving may be causing them physical and emotional problems. How do caregivers stay tuned in to their bodies, minds and spirits, so they know when we need a break? Often a short vacation from the responsibilities of caregiving can be helpful to both the caregiver and the care receiver.

Whether you are giving care to your elder in their home, your home or have some other arrangement, caregiving is a full-time job. Even when you aren't giving direct care, running errands or slogging through health insurance red tape, you have your elder's needs on your mind. Will he fall again? Will she remember her medications on time? Will they eat decently?

While most of us take on caregiving out of love, many of us find the full-time mental and emotional stress of caregiving wearing. This wear on our body and mind can put us at risk for our own health problems. Statistics vary, but most show upward of 30% of the caregivers die - yes die - before the person they are caring for. And that isn't just elderly caregivers. That includes adult children who die because of anything from undetected cancers to suicide. Don't let stress overload get this bad.

What Signals Stress Overload?

• You are skipping your own physicals

• You are isolating

• You are drinking and/or eating too much for good health

• You are short tempered with your spouse, your kids and the elder you are caring for

Let's look at these signals one by one:

You Are Skipping Your Own Physicals

I personally know two caregivers who are cancer survivors. I also had a friend who died of breast cancer. All three of these women had cancers that could have been caught early, but they put off mammograms because the whole process was too much bother. They were healthy, right? Their checkups could wait. Would they have gotten cancer in the first place had caregiver stress not been part of their lives? That we'll never know.

When I was at the peak of my eldercare years, I put off a pap smear two years in a row, and a mammogram one year. With five elders to care for at the time, I spent so much time in clinics and scheduling doctor appointments that I couldn't bear the thought of picking up that phone and making one more appointment - for me. The idea of finding time to actually go to my own appointments seemed impossible. I was more fortunate than the friends I mention above. I didn't develop cancer. But I could have had a cancer growing and not had a clue until it went from a fairly simple case to one that needed hard core chemotherapy, which may or may not have worked. I was not smart. I hope you are smarter.

If you can't leave your elder alone, contact an in-home health agency and schedule some time with them for respite care. Use that time for your appointments and, while you're at it, use the remaining time for some fun. Both of these steps are good for your health.

You Are Isolating

Whether it's because we are too tired from our long days of giving care to others, or because we feel our friends are no longer interested in us because our lives have been overtaken by caring for our elders, caregivers often isolate.

We don't do this on purpose, and generally the process of isolation is just that - a process. It happens slowly. We start making excuses, many of them well founded, when we are asked out by friends. We then find our friends get tired of being turned down when they offer invitations, so they quit asking. Meanwhile, we aren't living in the moment. We are planning what we need to do the next day, or regretting some thought or action from the day before. We often don't even realize how isolated we are.

Socialization is good for people, as we are made to be social creatures. Even those of us who are not extremely social are designed to have a given amount of interaction with other humans. For our own health, and often that of the care receiver, we should have at least some type of social life. How do we accomplish this? Again, by reaching out for help.

We can hire an in-home care agency or investigate volunteer services, such as Senior Companions, to come in and take care of our elder for a time. Or, we can find a good adult day care center and start a regular day a week, or even half-day, of care for our elder. Then, we can take this time to go to coffee or supper with a friend. The point is, we do something to break the isolation. Talking with other caregivers in a support group, or even online qualifies, as well.

You are drinking and/or eating too much for your health

We humans generally seek comfort. When we don't find comfort in social outlets or other appropriate ways, we sometimes seek solace in food or alcohol. Neither is a bad source of comfort now and then. But when drinking becomes a refuge for our emotional pain, or food becomes such a comfort that we endanger our health, we are using these substances for the wrong reasons. We may need a break in our daily lives so we can get back in touch with our true feelings. Recognizing that we are eating or drinking too much for our own good can help us realize when we need to take a break from our duties.

You Are Short Tempered

Have you been snapping at your family lately? Have you been short with the elder who you have vowed to care for? Either is a sign that you are stressed and need a vacation from caregiving.

Take Your Own Emotional Temperature

Watch for these signs of emotional stress in yourself. If you can't identify your stress triggers, ask a close friend or family member to assess you, or you should seek counseling. Listen to that person if he or she says you are stressed and close to burning out. You probably are.