Self-Care for Caregivers – The Caring Generation®
The Caring Generation® Episode 43 June 17, 2020, On this caregiving radio program Pamela D Wilson, caregiving expert talks about Self Care for Caregivers and Online Caregiver Support Groups. Guest Dr. Christopher Crnich, Associate Professor of Infectious Disease at the Veterans Administration Hospital in Madison, WI shares research about Antibiotic Use in the Elderly who live in nursing homes.
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Self-Care for Caregivers and Online Caregiver Support Groups Radio Program Transcript
00:04 Announcer: Caregiving can sometimes feel like an impossible struggle. Caregivers may be torn between taking care of loved ones and trying to maintain balance in life. The good news is that it doesn’t have to be that way. The Caring Generation, with host Pamela D. Wilson, is here to focus on the conversation of caring. You’re not alone. In fact, you’re in exactly the right place to share stories and learn tips and resources to help you and your loved ones. So now, please welcome the host of The Caring Generation, Pamela D. Wilson.
00:48 Pamela D. Wilson: This is Pamela D. Wilson, caregiving expert, I’m your host. You’re listening to The Caring Generation radio program, coming to you live from the BBM Global Network, Channel 100, and TuneIn Radio. The Caring Generation focuses on conversations about health, well-being, caring for ourselves and loved ones, all tied together with humor and laughter that are essential to being a caregiver.
01:11 Pamela D. Wilson: On this program, we will be talking about self-care for caregivers and online caregiver support groups. Research confirms the role of being a caregiver poses significant effects on the health and well-being of the caregiver. The majority of caregivers watch elderly parents and loved ones experience failing health. We’ll talk about self-care for caregivers from two perspectives. The first is the idea that the experience of caring for a sick parent can serve as a warning sign to the caregiver to take better care of him or herself. That means you, the caregiver. The second perspective is from a caregiver who is concerned about being angry about being a caregiver and may be being unkind to a parent.
01:54 Pamela D. Wilson: Caregivers who are concerned about losing patience can feel guilty about being angry caring for an elderly parent who is kind and who tries to do as much for him or herself as possible. Many elderly parents don’t want to be a bother. But they do realize that living with their children does impact life. We’ll talk about how to manage the emotional stress of being a caregiver. How to set goals to move stuck situations forward. Tips for becoming more compassionate. Gaining support through online caregiver support groups or courses, and being persistent to keep going on days when we want to give up.
02:31 Pamela D. Wilson: Our guest for this caregiving radio program is Dr. Christopher Crnich, who is a faculty member in the Division of Infectious Disease within the Department of Medicine at the University of Wisconsin, Madison. He’s also the Chief of Medicine and the hospital epidemiologist at the William S. Middleton Memorial Veterans Hospital and the Assistant Director of Infection Control at the University of Wisconsin. Dr. Crnich specializes in infectious diseases and his research focuses on healthcare-associated infections among vulnerable elderly patients. For this interview, we’ll be talking about antibiotic use in nursing homes where many elderly live.
03:11 Pamela D. Wilson: Let’s start with the idea of self-care for caregivers and the idea of online caregiver support groups. One of my online caregiver support groups is on my Facebook page, pameladwilson.page, it’s called The Caregiving Trap. I had a caregiver join recently who said that she joined my online caregiver support group because she was unable to attend an in-person group due to COVID-19. On the caregiving podcast called Elder Care Programs and Elder Care Workplace Solutions, I talk about how COVID-19 has changed the lives of caregivers at work and at home. That caregiving podcast features an interview with Dr. Christopher Fagundes—different from the Christopher that we have tonight—who shares research about caregiver stress, the immune system, and chronic disease.
03:57 Pamela D. Wilson: These subjects, caregiver stress, the immune system, and chronic disease, lead us back to why that topic of self-care for caregivers is so important. If you are a caregiver for an elderly parent or a spouse, does being involved in their care, especially healthcare issues, have any effect on the way that you today think about your health? Self-care for caregivers is an essential part of being a caregiver. Being an active participant in self-care means that as caregivers, we work at not allowing caregiving tasks and responsibilities to significantly affect our lives, emotionally or physically. Including losing patience caring for an elderly parent. What holds caregivers back from creating a work-life caregiving balance? Sometimes it is the belief system of the caregiver that causes that imbalance.
04:51 Pamela D. Wilson: In my online caregiver support groups, I hear caregivers say things like, “If I don’t do it, no one will.” “I made a promise to care for my mother or father.” “Our family, we take care of our own.” And one of my favorites: “No one cares as much as I do, I’m the only one that can do this.” Caregivers choose to think in this manner, and behaviors follow. Our minds believe what we tell our minds. Our thoughts control our actions. For caregivers, making any one of these, “I have to do it all” statements can result in poor self-care for caregivers. Part of these beliefs may go back to our childhood or life experiences. If we don’t have any experience of goal-setting or becoming action-oriented to resolve problems, then we may not have the experience to close that caregiving gap that results in believing that we as caregivers have to do it all. We might even believe that self-care for caregivers is unimportant or unnecessary. That is so not true.
06:00 Pamela D. Wilson: What are some of the signs that self-care for caregivers is failing? How many of you are experiencing these? Sleep deprivation—you’re not getting enough sleep at night, or you’re not getting uninterrupted sleep. Your diet’s not great. You have headaches, stomach aches. You’re not exercising. You might be gaining weight. You might have a diagnosis of chronic disease. You may be feeling frustrated, impatient, anxious, and you’re not going to the doctor for routine and scheduled care. Frequent discussions about setting boundaries as a caregiver happen in my online caregiver support groups. We talk about this all the time. Especially those caregivers who will bring this up who have gone too far the other way. Caregivers who try to do it all, and today they are sick themselves. Breaking old patterns of a desire to want to feel indispensable, it’s difficult. Ask yourself, is not taking care of yourself a pattern that was modeled by your elderly parents? Are you modeling this behavior of not taking care of yourself or of being impatient with elderly parents for your children, who may one day become your caregivers? We all want to think about the examples that we set.
07:09 Pamela D. Wilson: Self-care for caregivers is a subject that should receive more attention, but it doesn’t. Do you wonder why? One reason is that others not involved in caregiving are really great—even fantastic—about making you feel guilty. Outsiders and caregiver, I call them caregiver-shamers, say, “Oh, caregiving can’t be all that difficult.” Or “You shouldn’t say those things about your mom, your dad, your husband, or your wife. Of course, it’s your duty to care for them.” Of course, we as caregivers know that. But it doesn’t mean it’s not stressful. If your family members are making these statements, ask them to help and give you a weekend off. Maybe after a weekend caring for your parents and their parents, they may feel a little differently. And a few days away from caregiving, it can be exactly what you need to help manage feelings of frustration or impatience, and to help you feel appreciative of all of the things that you do have in your life.
08:04 Pamela D. Wilson: There are so many positives if we can train our mind to think of the positives instead of the negative. We will talk more about self-care for caregivers and online caregiver support groups in the second half of this program. Up next, we have Dr. Christopher Crnich from the University of Wisconsin and the William S. Middleton Memorial Veterans Hospital. He’s going to talk about antibiotic use in the elderly living in nursing homes. Over the 20 years that I have worked in caregiving, I have had so many older adults living in nursing homes, and anytime something happened, the first thing was, “Oh, we need to give them an antibiotic.” He will tell us whether this is true or not.
08:43 Pamela D. Wilson: Helpful Information for Caregivers is in my Caring for Aging Parents Caregiving blog on my website at PamelaDWilson.com where there are plenty of articles and information for you. This is Pamela D. Wilson on the Caring Generation. You’re with me live on the BBM Global Network, Channel 100, and TuneIn Radio. Stay with me, we’ll be right back.
11:26 Pamela D. Wilson: This is Pamela D. Wilson, caregiving expert, I’m your host. You’re listening to The Caring Generation radio show for caregivers and aging adults, live from the BBM Global Network, Channel 100, and TuneIn Radio. With us is Dr. Christopher Crnich. Dr. Crnich, thank you for joining us.
11:44 Dr. Christopher Crnich: Well, thank you for having me, Pamela.
11:47 Pamela D. Wilson: My pleasure. So I found you through your research that specializes in the area of antibiotic use in nursing homes where a lot of older people reside, and I saw a statistic in one of your articles that talked about 75% of the prescribing of antibiotics being inappropriate. Who’s writing these orders in the nursing homes?
12:08 Dr. Christopher Crnich: Well, it depends on the resident. So, for long-term stay residents who are in these facilities as their home location, the antibiotics are often being prescribed by the primary care provider, or a nurse practitioner, or physician assistant who might be rounding on a regular basis in these facilities on behalf of the primary care physician, or often the medical director in those facilities. For long-term, or should I say, short-stay residents who are there rehabbing after a hospital stay often after surgery or for other reasons, they may be on an antibiotic course for treatment of an infection that was identified during their hospitalization. And so, the antibiotic course may be prescribed by a provider at the hospital or some specialist, like an infectious disease doctor like myself, who will be following these individuals in the clinic setting. So it really can vary. And then the last group is, these infections can sometimes be recognized after hours and so you may get a cross-covering provider or even an emergency room physician who is seeing these individuals on an urgent basis, who’s writing the prescription for these individuals.
13:33 Pamela D. Wilson: And so, you kind of talked about short-term and long-term stays and rehabs stays, and the antibiotics given are different, so, do residents ever contract health conditions from each other being in these communities that need antibiotic treatment?
13:50 Dr. Christopher Crnich: Yes, in somewhat of an indirect way. So, you’re absolutely correct that nursing homes are somewhat ideal environments for the transmission of communicable diseases. The infections that we kind of commonly see cause outbreaks in nursing homes. Well, we’re in the middle of one right now with COVID-19, obviously, but influenza and norovirus are viral infections that get transmitted from one resident to the next. However, antibiotic resistance in bacteria are often easily transmitted from one resident to the next, and while they may not necessarily manifest an infection immediately, they can cause colonization that in the future may cause infection. So, it’s not as clear-cut as we see with influenza or norovirus or COVID-19 where there’s kind of a short interval between acquisition of the viral pathogen and the manifestation of the illness. When residents acquire an antibiotic-resistant bacterium, it could be weeks. It could be months later that they develop an infection with those pathogens. And some residents never develop infections; they’re simply colonized. The other bacterial infection that we do see that’s spread in a communicable way is Clostridium difficile, which is a serious form of antibiotic-associated diarrhea, which I think we’ll talk about a little bit later on.
15:29 Pamela D. Wilson: Yes. So what are the risks for residents who are prescribed antibiotics all the time and they really don’t need them? What happens?
15:38 Dr. Christopher Crnich: Yeah, this is a point or topic that I really try to devote a lot of energy to educating my patients, family members, my trainees. Is that antibiotics, like any medication or medical intervention, has a potential downside. Unfortunately, we tend to look at antibiotics as these miracle drugs, and in many respects, they are. But like other medical therapies and medical interventions, they need to be used appropriately. And when they’re misused, they can result in harm, and the harms we see with antibiotics are several-fold. So the first is, we can see just adverse reactions to the medications themselves.
16:30 Dr. Christopher Crnich: Common antibiotics, like sulfa medications, for example, can cause kidney injuries. They can cause problems with electrolyte abnormalities. And every antibiotic we prescribe can have these adverse effects. And when you look at presentations to the emergency room from nursing homes, antibiotics are often one of the common triggers for presentations to the emergency room for adverse drug events. So that’s one potential side effect from antibiotics. The other is potentially drug interactions, and what I mean by that is, residents in nursing homes are often on a number of other medications, and when you prescribe certain antibiotics, they can interact with other medications or change how they’re metabolized. And then the last, which I already alluded to, is these antibiotics can select for resistance, and individuals can develop infections in the future that are caused by these organisms which are much harder to treat and associated with a lot of harms, including an increased risk of death. Those are just some of the things we worry about with antibiotics.
17:45 Pamela D. Wilson: And we’re headed now to a break, but I want to ask you a question, you can think about it during the break, and then when we come back, you can answer. So, how then do you, or any medical provider, look at an older person and say, “Okay, I think I need to write a prescription for an antibiotic.” How do you look at, are they going to have an adverse reaction? Are there drug reactions? Is something else going to happen? What do you look at? Is there any type of criteria that doctors have to go through before they write that prescription?
18:15 Pamela D. Wilson: So listeners, we’re going to continue our conversation after this break with Dr. Christopher Crnich. He is from the University of Wisconsin and the William S. Middleton Memorial Veterans Hospital, where he specializes in infectious disease research. We’re talking about antibiotic use in nursing homes. You can check out the best podcasts for caregivers on my website. This show will be up in about a week. If you have people that you would like to share it with, you can go to the media tab and then The Caring Generation radio show tab to find it. I’m Pamela D. Wilson, your host. You are listening to The Caring Generation live on the BBM Global Network, Channel 100, and TuneIn Radio. Stay with me, we’ll be right back.
21:09 Pamela D. Wilson: This is Pamela D. Wilson, caregiving expert, I’m your host. You’re listening to The Caring Generation, live on the BBM Global Network, Channel 100, and TuneIn Radio. We’re back to continue our conversation with Dr. Christopher Crnich. So doctor, before the break, I was asking you a question. You’re thinking about prescribing an antibiotic, what do you and most physicians look at?
21:30 Dr. Christopher Crnich: Great question, Pamela. So, what we try to focus on is, do we have concrete evidence of infection, and there are a lot of localizing and general symptoms that often trigger concern for infection. So often, we’re looking for things like fever and localizing symptoms. So for example, if we’re suspicious of pneumonia, we’re often looking for things like cough, shortness of breath, change in sputum. And we’ve developed a minimum criterion for initiation of antibiotics in these facilities called the Loeb criteria that are often used as an initial threshold. But obviously, every resident is unique, and so having a good understanding of that individual’s prior history and how infection manifests in them can also be an additional tool that we utilize to determine whether we should be initiating antibiotics in a particular resident.
22:28 Pamela D. Wilson: Earlier in our interview, you were talking about clients who get diagnosed with C. Diff., can you explain what that is, and how severe it is, and does it come and go?
22:38 Dr. Christopher Crnich: Absolutely. So, Clostridium difficile is a bacteria that’s resistant to a number of antibiotics and can exist in our intestinal tract in low numbers, and it’s normally not able to cause problems in normal individuals because of the presence of other normal bacteria in our intestinal tract. However, when you give antibiotics to an individual that may have low numbers of C. Difficile in their intestinal tract, that bacteria can overgrow and dominate the intestinal tract because the antibiotic that you’re giving has wiped out the other good bacteria in the intestinal tract, and this bacteria can produce toxins that cause injury to the colon. And these people get what we call colitis, which can be life-threatening, and a number of patients can go on to require surgery to have their colon removed. And if that doesn’t work, obviously, death is a common outcome that we see with this very serious infection. And so, preventing it through judicious use of antibiotics is something that we’re always keeping in mind when we prescribe, particularly to older adults who reside in nursing homes.
23:58 Pamela D. Wilson: So what conversation would you have with maybe a resident or a family member who’s saying, “Well, do my parents need an antibiotic, don’t they, do they?” How do you talk to family members about that?
24:07 Dr. Christopher Crnich: Yes, so, a lot of times, requests from family members to consider starting an antibiotic are being triggered by subtle, non-specific abnormalities, like a change in behavior, irritability, other kind of subtle things. They’re having difficulty reading or sleeping, “Could they have a urinary tract infection?” is a common question that we hear from family members. And that probably is one of the most common scenarios for triggering antibiotic use. So what I really try to do with family members in those scenarios is really kind of walk them through that those symptoms can be triggered by a lot of underlying conditions, not just infection. Things like pain, things like depression, perhaps they had a change in one of their other medications that could be triggering that behavioral disorder.
25:00 Dr. Christopher Crnich: What I really try to do in those situations is, “I want to make sure what’s best for your family member and it’s important that we figure out why they’re having this change in condition, but I don’t want tp prescribe an antibiotic unless I feel absolutely sure that they have an infection because of the side effects that we described earlier. So, I usually ask them to give me some time to work through with these individuals, what else could be triggering that behavior change.
25:29 Dr. Christopher Crnich: Now, when there’s kind of clear-cut evidence of infection, fever, other vital sign abnormalities, clear-cut localizing symptoms, like pneumonia that I described earlier, then that’s a no-brainer, you start an antibiotic in those situations. But I’d say the majority of antibiotics in nursing homes get started under these kind of less non-specific changes in condition, and under those scenarios, we really have to take our time and work through to figure out what could be going on. And a lot of times, it’s not an infection and if we can avoid an antibiotic in those situations, we’re really providing a lot of benefit to those residents. And in most situations, I think resident families really appreciate that kind of detailed and thoughtful approach to working up what’s going on with their loved one.
26:18 Pamela D. Wilson: And then what happens if the family member, let’s say you’re saying, “Well, I’m not sure,” or “I need three days,” and the family members are just having a fit and they’re saying, “No, we’ve got to do something now,” and they want to send them out to the hospital. Do nursing homes tend, I mean, do you as a doctor say, “No, they can’t go out to the hospital to be evaluated,” or “We need to keep them here”? How do you respond to family members who get really stressed about that?
26:39 Dr. Christopher Crnich: Well, I think you’re describing a common scenario, and as I said, trying to build trust with the family is really important upfront, and demonstrating that you really do have their loved one’s best interest at heart can go a long way to defusing those situations. In the heat of the moment, that really isn’t a situation where you want to be getting into an argument with a family member, and so I think, I try to have these conversations upfront before there’s kind of a change in condition. And so, I think establishing a relationship, establishing trust upfront, is really the key here. But obviously, if a family member is going to want to get a second opinion, they’re absolutely entitled to pursue the second opinion, and I wouldn’t get in the way of that.
27:34 Pamela D. Wilson: Where can consumers go to learn more about antibiotics?
27:38 Dr. Christopher Crnich: That’s a great question. So, the Centers for Disease Control and Prevention has excellent resources for long-term care facilities around antibiotic use and infections. The Agency for Healthcare Research and Quality also has some excellent resources for family and residents. And here in Wisconsin, we’ve developed a number of online resources which can be found on the Wisconsin Clinical Resource Center. A lot of those resources are built for providers that manage residents and long-term care facilities, but there are a number of resources there that I think family members can find that are quite useful for learning more about the judicious use of antibiotics in nursing homes.
28:33 Pamela D. Wilson: And is there a website for that, or what would they Google to find it?
28:38 Dr. Christopher Crnich: So if they just Google the Wisconsin Clinical Resource Center, they’ll be taken to that site.
28:45 Pamela D. Wilson: Okay, perfect. Dr. Crnich, thank you so much for joining us. Listeners, we are going to go into a break. This is Pamela D. Wilson, your host, you’re listening to The Caring Generation, live on the BBM Global Network, Channel 100, and TuneIn Radio. Stay with me, we’ll be right back.
31:21 Pamela D. Wilson: This is Pamela D. Wilson, caregiving expert, I’m your host. You’re listening to The Caring Generation radio program for caregivers and aging adults coming to you live from the BBM Global Network, Channel 100, and TuneIn radio. The Caring Generation focuses on the conversation of caring, giving us permission to talk about aging, the challenges of caregiving, health, and everything in between. I want to give the website that Dr. Crnich mentioned for antibiotic research, so if you have a pen, it is www.crc.chsra.wisc.edu. That’s where you can find information about antibiotic use for your elderly parents and yourself.
32:00 Pamela D. Wilson: So, back to our prior subject. So early in the program, we were talking about self-care for caregivers, including what I call learned and modeled behaviors that our parents passed down to children and that we pass down to children. So the question to ask is, which behaviors, like being negative or being closed-minded, can we unlearn? Caregivers in my online support groups ask if they’re being selfish by putting their health needs as the caregiver before the needs of others. What do you think? The answer is, heavens, no!
32:27 Pamela D. Wilson: Here’s why: When the caregiver is sick, it’s difficult for you to provide good care for an elderly parent. And then we have these caregiving emotions that come into the picture, which are a significant cause of stress. So if we think about the goal of improving self-care for caregivers, how can we manage our emotions so that they don’t become a negative? The first is we have to notice our emotions. So, are you as a person generally positive or generally negative? Do you recognize the types of people, events, or situations that trigger your emotions to that dark side over to the negative? If you don’t, you might want to start by paying attention to times when your thoughts turn negative. When you become impatient. When you’re upset. When you feel angry toward other people, and then look at what caused you to feel that way. That thing that upsets you is that emotional trigger. And I talk about this on another podcast. It’s called My Mother is Crazy. It’s a great podcast, I interview a guest about emotional triggers.
33:23 Pamela D. Wilson: So if we take caregiving emotions and we translate that idea to a larger scale, which is what really is happening now in caregiving relationships that were started by the coronavirus, it’s the whole thing about, what’s on the news today? What are we supposed to worry about? I don’t know about you, but honestly, I have stopped watching the news, except for the weather forecast. I am so much happier and much less stressed. The news and this is my opinion, it provokes the public, the emotions, and sometimes not in a good way. It’s as if the news wants to tell us how we should think rather than giving us two sides of a story so that we can make up our own minds. You can relate this to caregiving news, because when caregiving emotions run high, it’s easy to take news from a parent, a brother, or a sister, and we just blow it out of proportion.
34:10 Pamela D. Wilson: In other situations, somebody’s intention might be good but we perceive it as being bad because maybe we’ve had a bad day. Doctors can speak in medical terms that caregivers, we don’t know what the heck they’re talking about. Caregiving news, sometimes, it’s not good. It could be about a disease progressing or the health of a parent getting worse or better. That freaks us out. So what can we learn about how to respond to news? The lesson here is that we have the ability to control our environment. Which is our mind. If you’re constantly negative, stop watching the news. Start watching something that makes you laugh. Self-care for caregivers means that we can evaluate and fact-check information instead of letting it upset us. We can allow emotions to take our day off-track, or we can recognize the emotion for what it is and decide how we want to respond.
35:00 Pamela D. Wilson: One of my favorite quotes by Eleanor Roosevelt is, “To handle yourself, use your head; to handle others, use your heart.” We can end toxic situations by changing our actions and our responses. Relative to working with the medical profession, don’t allow doctors to convince you to do something that you’re not comfortable with, that you don’t feel is right. Keep asking questions until you’re comfortable until you feel like you have enough information to make an informed decision. The older that we get, and there’s research about this, it’s more challenging to make decisions, because sometimes we get set in our ways, we may be less open-minded. Online caregiver support groups are great places where you can talk about the pros and cons of ideas so that you can decide. In my groups, a lot of caregivers will ask questions and they get a lot of opinions from me and from other caregivers, good and bad.
35:48 Pamela D. Wilson: Self-care for caregivers means that we may try something that doesn’t work out. But then, rather than beating ourselves up for what we see as a mistake, we can use our head to evaluate the situation. What went well? What didn’t go well? What happened?. When we evaluate these choices, we can look at things from a factual thought process and kind of send our emotions away. It’s not to say that we don’t want to be emotional. We can, but sometimes we make better decisions when we are factual.
36:15 Pamela D. Wilson: Another issue with participating in online caregiver support groups is sometimes other caregivers can help us see how we can influence a situation rather than feeling that we are at the mercy of our family members, or the healthcare system, or other people. Other caregivers can help us look at what resources or strengths that we have, or help us identify new resources so that we can move forward with a plan. We all know that caregiving is not perfect, and things don’t always go right, and the unexpected happens. If we can recognize this as just the way that it is, sometimes we can place our minds and our emotions in a mode where our tempers don’t flare up, and we can think about how to react to situations instead of responding in ways that may not be helpful. Thinking this way can become a new habit. We always don’t want to believe everything that we see or hear. I am a true believer in that. We want to ask questions to evaluate information as accurate or not. We want to gather new information and then move forward, especially when you’re making decisions about the health of your elderly parents.
37:20 Pamela D. Wilson: If the uncertainty of your care situation has you feeling a little uncomfortable, you can check out my caring for aging parents blog post called The Four Stages of Caregiving. I’ll put a link here in the radio show transcript for you. We will continue our conversation about self-care for caregivers and the benefits of online caregiver support groups after this break. Helpful information for caregivers and aging adults is on my website and in my caregiving library at PamelaDWilson.com. You’ll also find information about my caregiving book. It is called The Caregiving Trap: Solutions for Life’s Unexpected Changes. My goal is to help caregivers plan ahead, to realize that unexpected things happen, and to be prepared instead of being panicked or feeling like you have to respond to crisis all the time. It’s a very uncomfortable place to be, and it definitely doesn’t help you take care of yourself so that you can take care of the elderly parents. This is Pamela D. Wilson, caregiving expert, author, and speaker. You’re with me on The Caring Generation, live from the BBM Global Network, Channel 100, and TuneIn Radio. Stay with me, we’ll be right back after this break.
40:44 Pamela D. Wilson: This is Pamela D. Wilson, caregiving expert, author, and speaker. This is The Caring Generation coming to you live from the BBM Global Network, Channel 100, and TuneIn Radio. Let’s talk about more ideas around the subject of self-care for caregivers. If you’re facing a situation that is not perfect, what are you willing to do to improve or change? Are you willing to write down on a piece of paper what a better situation looks like, and then figure out how to get there? What steps it takes to get there? As we talked, there are no perfect caregiving situations.
41:17 Pamela D. Wilson: For self-care for caregivers, it means eliminating that negative self-talk in our head from our vocabulary in our minds. It means not saying or thinking things like, “Oh, I never do anything right.” “This is impossible.” “Why should I change? It’s not going to make a difference,” or “There’s no way I can find time to do X.” Thinking like that won’t help you get to where you want to be in a caregiving situation. The problem is, because caregiving isn’t something that anyone teaches us to do, unless of course, our elderly parents modeled their behaviors of taking care of our grandparents. Where should caregivers turn for help? It’s others who have experience with similar situations I find to be the best. That leads us back to the benefits of online caregiver support groups, caregiver courses, family caregiver training, and caregiver programs. A lot of caregivers say, “Well, I don’t have time.” Well, do you have time to let your situation get worse instead of better?
42:18 Pamela D. Wilson: Another idea is if your workplace doesn’t have programs for family caregivers, start asking. This issue with the coronavirus that complicates caregiving, it is not going to go away for a while. Caregiving, we’ve seen it. It affects our minds, our emotions, our physical health, and we know that it affects our work and our home lives. And this really applies to all caregivers, including, God bless them, all these healthcare workers out there. Even though you might be a CNA or a nurse who works in a hospital system and you have specialized skills, once you try to navigate the emotional aspects of caregiving and systems outside of the system where you work, can be unfamiliar territory. We all bring our family caregiving issues to the workplace every day. Caregiving stress is real. It has significant effects on our emotions and our abilities to do our job.
43:06 Pamela D. Wilson: The way that we respond to stress is based on a lot of factors. Let’s talk about one, which is adversity. Adversity can be anything like the loss of a job—worrying about losing a job. It can come from outside sources, like the coronavirus, that we don’t control, or inside sources, like negative thinking and our mind. The idea of self-care for caregivers and participating in online caregiver support groups. It can help you manage through adverse times. Realizing that we need help is a positive factor when we think about how we want to change a situation. We certainly can stand by and do nothing, we can feel miserable, or we can choose to do something.
43:43 Pamela D. Wilson: A complicating factor for caregivers who may want to but who hesitate to take action is the idea of chronic stress. Caregiver stress grows the longer that you are a caregiver. Year one can be easy; by year 10, caregiving stress never goes away. When we think of chronic stress as a challenge and an opportunity to solve a problem rather than something we can’t solve, we can become motivated to change. So if we look at the situation of the coronavirus as adversity and challenge, we can realize that we may not be able to do much individually to change what happens in the world. But individually, we can have a huge effect, by social distancing and following good hygiene practices to avoid spreading or acquiring that virus. We can keep our families safe.
44:30 Pamela D. Wilson: On the other hand, what else can we do? Well, are there tasks at home that we’ve been meaning to get to that we haven’t because now we’re spending a little bit more time there? No time like the present. Have we been thinking about becoming more healthy but we’ve been putting it off? No time like the present. Self-care for caregivers involves finding ways to have our needs met to reduce all this mental stress. Safety is a need that relates to the coronavirus. A lot of us stayed home for 30 days, and then we stayed home for another 30 days, and some of us are still stuck at home. But we can’t stay locked up forever. Life doesn’t work that way. Now, we’re faced with looking at other ways to modify our behavior so that we can go out. Caregivers are asking me about going to doctor appointments and seeking regular medical care. Before we just picked up the phone, called a doctor, made an appointment, showed up.
45:18 Pamela D. Wilson: Today, we even have to call and find out if the doctor’s office is open. But then we should start asking about what procedures the office has in place to keep us safe. Are the chairs 6 feet apart? Is the staff taking temperatures upon arrival? These steps will keep everybody safe, They’ll keep us safe, and the staff who work in the medical offices. This new model of self-care for caregivers means being compassionate with ourselves and very considerate of others.
45:45 Pamela D. Wilson: Even more important is how we regulate our feelings and our emotions, as we talked about throughout this program. Self-care for caregivers transfers into the idea of becoming resilient to change, which we are all learning how to do, even though we don’t respond to change in the same way. That includes our elderly parents for whom we may be caring. They are experiencing a great deal of change. Some people find change exhilarating. Others find it challenging. The idea of being resilient to change that relates to self-care for caregivers is realizing that sometimes we need to let go of our emotional attachments to the things that are changing, because we may not be able to stop that change. As we and our elderly parents change and age, it’s going to be more complicated to get the healthcare that we need, and this is in part affected by the chronic diseases our elderly parents have, their weakened immune systems, as we talked about with Dr. Crnich. Some older adults take more antibiotics, those can cause problems.
46:41 Pamela D. Wilson: And as a result of all this, our elderly parents, they may become more anxious and dependent on us as caregivers as they need more assistance. So as a result, caregivers need more strategies, strategies for what is going to happen when you’re not available when your parents call. I had some elderly parents who would call their children at work 10 times a day or more. Is that happening to you? On the other hand, some caregivers worry every time that phone rings, that it might be bad news. So we have to learn to balance our emotions so we’re not up and down and up and down all day. Self-care for caregivers involves creating a backup plan so that we have a brother or sister that can help us when we need help.
47:20 Pamela D. Wilson: We’re going to continue to talk more about caregiver, resilience to change, coming up after this break. Because rather than being that caregiver who wants to do it all, we want to look at what other care solutions and what other situations can help us today, tomorrow, three months from now, a year from now. Because as caregivers, sometimes some of us are in it for the long haul. It’s more than a year, sometimes more than 10 years, sometimes 15 years. We’ll continue to talk more about this after the break. I’m Pamela D. Wilson, caregiving author, expert, and speaker. This is The Caring Generation live from the BBM Global Network, Channel 100, and TuneIn Radio. Stay with me, we’ll be right back.
51:21 Pamela D. Wilson: This is Pamela D. Wilson, caregiving expert, I’m your host. This is The Caring Generation radio program for caregivers and aging adults, live on the BBM Global Network, Channel 100, and TuneIn Radio. We’re back to talk about self-care for caregivers that involves becoming resilient to change by using what research calls active coping mechanisms. Active coping means that individual uses a variety of strategies to respond to stressful situations. This can include problem-solving, researching, information-seeking, obtaining professional help, planning, changing the environment, which could be your mind, and reframing problems. So, looking at problems differently. All of these strategies can be helpful in the right type of online caregiver support groups and through our own behaviors.
52:08 Pamela D. Wilson: We talked throughout the program about our ability to change our personal environment, which is our mind, and how we react to situations. If you try this, you know that by changing the way that you respond, you can actually begin to change the responses of others, which could be your elderly parents. A person who may have previously known what button to push to upset you doesn’t work anymore when you realize what’s happening. If becoming impatient with an elderly parent was a previous issue, you might know now that by being more compassionate with an elderly person who might be struggling or fearful of how their life is changing, you can be more empathetic and patient, and it’ll calm them down. You can also realize that chronic stress can really affect moods and physical health. Maybe you decide to exercise every day, go take a walk, meditate. Maybe you take an entire day off every week away from caregiving, because you’ve convinced your brother or sister to come spend the day with mom or dad.
53:04 Pamela D. Wilson: For caregivers who want support with problem-solving and information-seeking, an online caregiver support group is a great place to start. All the better if the group is led by a caregiving expert who has professional expertise to offer to the group. Another option is maybe to go work with a private counselor if you have a lot of concerns and you want your information to stay confidential. Whatever you do, find a situation that works for you and creates routines to support self-care and caregiving tasks. The radio show podcast called Caregiving Survival Skills, it offers a lot more ideas on how to manage through challenging caregiving situations. You can find it on my website at PamelaDWilson.com. Go to the media tab, The Caring Generation radio show, and scroll down.
53:47 Pamela D. Wilson: Just the fact that you are here seeking information means that you have a desire to improve your health, your well-being, and your caregiving skills. Also, meet other caregivers and embrace those relationships. Continue to seek information, to ask questions. Everything that you learn in caring for your elderly parent or your spouse translates to your ability to care for yourself and to model your behavior for your children. Pass the good stuff down to generation after generation. Know that in caregiving, there’s no silly questions. No unreasonable concerns. If you have a worry, it’s valid. Recognize your feelings. Face your fears. Use active coping skills to manage the roles and responsibilities of being a caregiver. Only you can take care of you.
54:33 Pamela D. Wilson: God bless you all, and thank you for being caregivers. Caregivers are not appreciated enough. Invite your family, friends, co-workers, social groups, care communities, medical offices, and human resource departments to join us every Wednesday evening on The Caring Generation radio program. Follow The Caring Generation podcast on Apple, Google, Spreaker, and your favorite podcast sites. Information about caregiver training and education onsite or through caregiving videoconferencing is on my website at PamelaDWilson.com. My blog is there, all these radio show podcasts are there, my book, The Caregiving Trap. My caregiving library has hundreds of articles for family and professional caregivers, and it’s all free. All you have to do is go to the website at PamelaDWilson.com.
55:19 Pamela D. Wilson: Listeners, it has been a pleasure being with you this evening. I am Pamela D. Wilson, caregiving expert, advocate, author, and speaker. Join other caregivers, find ways to support self-care for yourself. Start sleeping nights. Start watching funny television shows. Stay away from the news. Evaluate information for your elderly parents, and make good choices. God bless you all, sleep well tonight, have a fabulous day tomorrow, and a great week until we are together again. You’re with me on the BBM Global Network, Channel 100, and TuneIn Radio, I’ll talk to you next week.
55:54 Announcer: Tune in each week for The Caring Generation with host Pamela D. Wilson. Come join the conversation and see how Pamela can provide solutions and peace of mind for everyone, here on Pamela D. Wilson’s The Caring Generation.