SIGNS, SYMPTOMS, CAUSES AND COPING MECHANISMS

How often is freedom taken for granted by each and every one of us? A trip to the supermarket, a visit to the park to walk the dog, a visit to the salon to get a haircut, or running out for ice cream. All these things can be done by anyone, until there is someone in the house that requires twenty-four hour care. A fall in the bathroom may cause a fractured hip; a drink consumed may accidentally cause choking; and if a loved one has Alzheimer's, they may wander away from home. These practical difficulties have the potential to result in caregiver burnout.

Burnout is a state of emotional, mental, and physical exhaustion. It occurs when caregivers don't get the help that they need or if they try to do more than they are able to do emotionally or physically. Causes of caregiver burnout are similar to the causes of stress; the difference being stress is looked at as too much of something and caregiver burnout is looked at as not enough of something. Not enough support, time, knowledge about the disease process, or finances.

Some of the causes of burnout are:

• Role confusion: It is difficult to separate the role of caregiver from, spouse, lover, child, friend, etc.
• Lack of control: Caregivers become frustrated by the lack of finances, resources, skills to efficiently plan, manage and organize their lives and their loved ones lives.
• Unrealistic expectations: Many caregivers expect their involvement to have a positive gain on the health and happiness of the patient. This may be unrealistic for a patient suffering from a progressive disease such as Parkinson's or Alzheimer's.
• Unreasonable demands: Some caregivers place unreasonable burdens upon themselves because they often think that providing care is their exclusive responsibility when it is not.
• Other factors: Caregivers often cannot recognize why they are suffering caregiver burnout, eventually get sick themselves and are not able to function efficiently.

If any of these causes are present in your life as a caregiver, you may potentially be a sufferer of caregiver burnout.

Burnout doesn't happen overnight --- it is a gradual process that takes place over an extended period of time. Once burnout occurs caregiving is no long a healthy option for you or the loved one you are caring for. Because of this, it is important to be able and aware to recognize the warning signs right away when they start.

Some of the warning signs are:

• You neglect your own needs, either because you are too busy or do not care anymore
• Change in appetite, weight, or both
• Getting sick more often
• Emotional and physical exhaustion
• Your life revolves around caregiving and it provides little satisfaction
• Withdrawing from social events
• Withdrawing from friends, family, and love ones
• Irritability
• Losing interest in activities that you use to enjoy
• You feel overwhelmed, helpless, and hopeless
• Feeling increasingly resentful

If any of these warning signs are present in your life, it may be time to seek assistance or make a change in your routine as a caregiver.

How to prevent burnout

Because burnout is a gradual process and it is sometimes hard to recognize. It is important to understand the warning signs and be able to defuse early on in the caregiving process so that burnout does not occur.

The three key areas in preventing burnout are:

1. Get the help that you need
2. Find emotional support
3. Take care of yourself and your needs

1) Get the help you need: Do not try to be all things to all people. As a caregiver, a surefire way of burnout is taking on all of the responsibility of a caregiver without regular breaks or assistance from others. Enlist friends and family to provide assistance with running errands, providing meals, or providing care for the loved one so that the caregiver is able to take a break. Also, most communities have caregiver services that are provided on a fee based system. These services can be obtained through local Area on Aging agencies, senior centers, adult daycare centers, home health agencies, community Meals on Wheels programs, transportation service programs, respite care, and skilled nursing services. By requesting help when you need it, allows you the ability to find emotional support and have the time to take care of yourself mentally and physically.

2) Find emotional support: One of the warning signs for caregiver burnout is withdrawing from social events, friends, family, and loved ones. It is important to share what you are going through with at least one other person, trusted friend, or family member. This can be gained by joining a support group, seeing a counselor or therapist, or drawing on your faith. Support groups are a very valuable tool; it allows you to share your troubles and seek out people that are going through the same troubles. The best value in a support group is that you find out that you are not alone; you will feel better knowing that other people are in the same situation, and their knowledge is invaluable if they are dealing with the same illness that you are dealing with. To find a community support group; ask your doctor, hospital social worker, search the internet or call a local organization that deals with the health problem that you would address in a support group.

3) Take care of yourself: To continue to be a caregiver for someone, you will need to find time to nurture yourself, even when it seems impossible. To continue to have the mental and physical strength that you need to deal with all of the stress related to being a caregiver, you will need to find the time to care for yourself. Give yourself permission to rest and do things that you enjoy on a daily basis. You will be a better caregiver if you can accomplish this key step. This entails doing activities that give you pleasure even when you do not feel like it, pampering yourself, eating a balanced diet, laughing, keeping a journal, and finding a trusted friend or family member to give you time off from being the caregiver.

What to do once you realize that you have reached the burnout point:

Oftentimes, by the time burnout is realized, it's too late to prevent burnout; the braking point has already passed. When this happens, it's important to take your burnout very seriously. Trying to push through the exhaustion and continue as your have been will only cause further emotional and physical damage.

While the tips for preventing burnout are still helping at this stage, recovery requires additional steps. The first step is to slow down, get help, and finally reevaluate your goals and priorities.

Slow down: When you've reached the final stages of burnout, adjusting your attitude or looking after your health isn't going to solve the problem. You need to force yourself to slow down or take a break. Cut back whatever commitments and activities you can. Give yourself time to rest, reflect, and heal.

Get support: When you're burned out, the natural tendency is to protect what little energy you have left by isolating yourself. But your friend and family are more important then ever during difficult times. Turn to your loved ones for support. Simply sharing your feelings with another person can relieve some of the burden.

Reevaluate your goals and priorities: Burnout is a true sign that something in your life is not working. Take time to think about your hopes, goals, and dreams. Are you neglecting something that is truly important to you? Burnout can be an opportunity to rediscover what really makes you happy and to change courses accordingly.

Debbie Adams, LMSW, MSM, Client Care Coordinator