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Understanding Stress and Sources of Help

Introduction

It is important to realize that although illness and its symptoms affect the patient, illness has an affect on the entire family. Caring for loved ones at home can be very rewarding, however it is physically and emotionally demanding for all family members.

During the illness, the patient may act in an angry way towards caregivers. This can cause hurt or angry feelings in caregivers. In most cases, the patient's behavior actually means "why did this have to happen to me?" This behavior is most often directed at persons who will continue to love and care for them in spite of these bad moods.

When the patient does act out in this way, it is a good idea to discuss your feelings about this behavior. It is common for the patient to be unaware of the change in behavior. Caregivers and patients are encouraged to share their fears and feelings with members of the hospice / home care team (nurses, social workers, pastoral care personnel). This team is prepared to help the entire family cope with changes during the illness.

The physical demands of caregiving are often strenuous. It is important that the family caregiver take time away from the responsibilities of caring for the patient's needs. It is important for the caregiver to have rest and relief outside of the home in order to maintain physical and emotional health. It is important to recruit other family members, friends, and the volunteers associated with the home care agency, to provide a break for the family caregiver.

Assessment

Anxiety is a common reaction and normal response to new and stressful situations.

Feelings that may indicate anxiety include:

• Nervousness
• Tension
• Panicky feeling
• Fear
• Feeling something bad is going to happen
• Feeling like "I'm losing control"
• Forgetfulness

Physical symptoms of anxiety include:

• Sweaty palms
• Upset stomach
• Tightness in stomach
• Shaking or tremors
• Difficulty breathing
• Fast pulse
• Red, flushed face and neck

Call the nurse or social worker if any of the following symptoms last for several days:

• Severe problems falling or staying asleep several days in a row
• Feelings of dread and apprehension
• Trembling, twitching, feeling "shaky"
• Fluttering stomach with nausea and diarrhea
• Rapid heart rate
• Wide mood swings that you cannot control
• Shortness of breath

Keys to controlling anxiety:

• Understanding the thoughts that are causing the anxiety.

Intervention

Family caregivers need to take care of their own needs for rest, food, enjoyment, and relaxation on a daily basis in order to remain physically and emotionally effective.

Be realistic about what you expect of yourself as a family caregiver. Don't expect to be perfect. If there are some parts of caregiving that are especially difficult for you, then ask others for help.

If you are finding that the caregiving demands are more than you can handle, it is important to discuss this with the hospice / home care nurse or social worker who will offer you information about getting help.

Tips for staying physically well:

• Get 6 hours of sleep at night, and take naps while the patient is sleeping during the day.
• Recruit other family members and friends to help with some of the caregiving (fixing meals, washing clothes, etc.) to reduce the caregiving burden.
• Use the volunteer assistance offered by the hospice / home care agency to help with grocery shopping, errands, or to give the caregiver "time off duty."
• Reduce caffeine intake (coffee, tea, caffeinated soda).
• Do not use alcohol or drugs to help reduce stress.
• Do not increase cigarette smoking.
• Eat a diet that includes protein and fresh fruits and vegetables.
• Treat yourself to some time for your favorite activity (listening to music, reading, TV program, walk outdoors, talk with a friend, etc.).
• Try to use relaxation exercise, yoga instructions, deep breathing exercise, or relaxation audio tape to help calm and relax you at least once a day.

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