Self Care for the Caregiver
November 2008
by Lois D. Knutson
Ann and Stan had been married for 58 years. Until recently, they had been active church members. Ann’s cancer was in remission, but she suffered from painful fibromyalgia and arthritis. Stan had a form of dementia. He still lived at home because Ann insisted on caring for him.
Stan was incontinent, fell out of bed often, hallucinated, was barely responsive, and was occasionally abusive. Ann tried to do everything for Stan at home, helping him with his most basic needs. She was also responsible for all the household chores. And because Stan had managed their finances and medical forms until his illness, she had to learn how to do that, too. Stan did attend adult day care twice a week, and for that Ann was very grateful. Still, she was worn out and depressed. She developed high blood pressure and severe back pain. Their only child was disabled, lived in a group home in another city, and was unable to help.
When Sally was downsized out of her job of 25 years, her parents offered to pay her to take care of them. They wanted to spend their last years in the home they had lived in all their married life. Sally weighed the pros and cons, and decided she was called by God to take care of her parents. Being single and an only child made the decision easier for her.
After her mother died, Sally’s father began to need more help and attention. The result was that Sally could no longer leave the house to shop, play tennis, or go for walks. Because her father’s sleep was increasingly interrupted by a need to visit the bathroom, neither of them felt very rested. Sally began to develop her own health problems, so she increased the hours that professional home health workers provided for her father. That and respite care services enabled her to leave the house, attend worship, and get some much needed time to herself.
Marianne was a successful businesswoman who lived halfway across the country from her mother, whose health was deteriorating. She made several expensive trips to spend time with her mother and arrange for her care before she made the risky decision to take a leave of absence from work and stay with her. She realized she might not have a job when she returned. Her father had died three years ago. Although she didn’t attend church regularly, Marianne did believe in eternal life through Jesus’ death and resurrection, and she felt that God was calling her to be near her mother as she died.
Caregiving as a calling
Being a caregiver can be a calling from God. Nonetheless, it can be overwhelming. It is an honor and a blessing; but it can also be disheartening and exhausting. Perhaps you care for a spouse, an adult child, a parent, or another loved one near death. Maybe you care for someone in your home or you visit her regularly at a hospital or nursing home. If you don’t care for someone now, the time will surely come.
How does a caregiver not lose heart? How can a caregiver avoid being discouraged? If you are a caregiver, how can you maintain the emotional and psychological strength it takes to care for someone you love?
First, consider caregiving a spiritual calling from God, based upon Luke 10:27: “Love the Lord your God with all your heart, and with all your soul, and with all your strength, and with all your mind; and love your neighbor as yourself.”
If we follow this commandment to love God, neighbor (the person we are caring for), and self, God gives us peace that boosts our spirit. As a result, we do not give up, even when faced with the most stressful challenges. We know that God loves us, inspires us, strengthens us, and guides us.
Second, take care of yourself, both spiritually and psychologically. The wellbeing of caregivers is important to God, to our loved ones who need care, and to ourselves. If we do not take care of ourselves, our effectiveness as caregivers will diminish. So pray, exercise, seek counsel, and hire outside help to help you with your responsibilities.
Third, use the practical tips that follow in the rest of the article. You may also search out help for your specific type of caregiving situation by visiting Web sites listed in Health Wise.
Taking care of a loved one
Whether you take care of your spouse, whom you have lived with and loved for many years, or a parent or sibling, there are a few things to keep in mind.
First and foremost, love yourself. In addition to being a spiritual command, loving yourself means taking care of yourself. And that’s important— exhaustion can lead to your own illness. If you are sick, you are less able to care for yourself or your loved one.
Ask for help—from family members, friends, caregiver support groups, pastors, professional counselors, home health care agencies, and respite care agencies.
Use a scale of one to 10 to periodically (and honestly) evaluate your ability to continue to provide care, both physically and psychologically.
Take care of your spiritual needs. Create a prayer corner with a comfortable chair and small table for your Bible. Keep a list of your favorite Bible verses nearby, along with a candle or treasured spiritual keepsake. Just as Jesus withdrew to a quiet place to pray, this can be your quiet place to get close to God. Go there before your loved one wakes up, or when he or she is napping or attending adult day care. Write down and revisit personal affirmations that boost your spirit.
Think ahead. When you drive your loved one to medical appointments, take along an updated medical information form with notes on current medications, names of physicians, and symptoms or behaviors. Allow extra time when going to appointments. It takes time to get two people ready, into the car, and into the building. Visit the washrooms before an appointment so you and your loved one are not anxious while waiting to see the doctor.
Taking care of a loved one in your home
Before deciding to take care of a parent or other loved one in your home, discuss with each other the challenges of living together. Consider whether the home is big enough for everybody’s personal items and privacy. Do you have children living at home? Is there a pet involved? Are there thermostats in each sleeping area of the house—which might be needed to regulate the differences in a younger and older person’s body temperature? Hold regular conferences (on the telephone or in person) with siblings so they will know what help you need with doctor’s visits, finances, chores, and medical decisions.
Develop caregiving goals that move beyond tasks. For example, set a goal to help your parent experience unconditional love and honor. Remember to respect her values and wishes.
Do your best to make her life easier; help with her spiritual life and offer a peaceful existence.
Engage in your own spiritual self-care. Know that you will become weary at times. When you’re tired or discouraged, focus on the blessings of caregiving such as knowing you will one day look back on this period and recall it as some of the last days you spent with your parent.
Dying and death
What is important for caregivers whose loved ones are nearing death?
As early as possible, encourage your loved one to complete a health care directive and plan a memorial or funeral service. You might ask questions such as, “Is there anything you’d like to say to anyone before you die?” or “What do you look forward to the most in heaven?”
Since spiritual caregiving takes on its deepest dimension toward the end of your loved one’s life, consider the following caregiving goals: I will help my loved one draw close to Jesus so that she will die in spiritual peace. I will keep her as comfortable as possible as the end draws near. I will relate to her in such a way that after her death, I will be at peace because I know I cared for her with Christ-like love.
Honor your loved one with tenderness, dignity, respect, compassion, and love. Make her (and only her, not other relatives or visitors) your focus at her bedside. Read recommended Bible passages—to her, and to yourself when she is resting. Tenderly and intentionally say good-bye to your loved one. Say “I love you” many times. Tell her how important she has been in your life and assure her that she will always be important to you. Thank her for everything she did for you and tell her about the most important things. Affirm her for being courageous and loving, and other attributes that apply. If necessary, give her permission to die.
All of us want to be tender-hearted, kind, competent, and compassionate caregivers. As we place a spiritual focus upon our caregiving role, God fills us with inspiration and peace so that we do not lose heart. God’s heart continually touches our hearts and fills us with love so that we can fulfill our spiritual calling.
Sometimes caregivers are not thanked for what they do and who they are. Today I say, “Thank you. Thank you for being a caregiver.”
The Rev. Lois D. Knutson is the author of Compassionate Caregiving—Practical Help and Spiritual Encouragement (www.bethanyhouse.com). She is a chaplain at Bartels Lutheran Retirement Community in Waverly, Iowa, and a speaker on topics of caregiving and aging. She is also her mother’s primary caregiver. You can reach her at kairostpt@ yahoo.com.
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