Family caregivers are frequently the subject of research studies about stress. For good reason! As grown-up children care for aging parents, they are faced with many new physical, emotional, financial, and practical demands. And this on top of their already-busy lives!
In a 2023 mental health report, AARP stated that family caregivers felt their caregiving responsibilities had caused an increase in these effects:
Stress (65%)
Worry (61%)
Concern about the future (60%)
Anxiety (57%)
Sadness/depression (45%)
Loneliness (38%)
Anger (27%)
A surprising 40 percent say they rarely or never feel relaxed.
You are not alone if you are feeling stressed out!
Luckily, there are ways to manage stress so it does not run your life. It requires attention and time, though. It may mean you have to look at beliefs about yourself. You may have to take risks. You might need to say things or behave in ways that are new and perhaps uncomfortable. And sometimes it will require letting go, realizing you can’t do it all, and asking for help. For instance, you need time away from caregiving responsibilities to recharge your batteries. And hard as it may seem to be, experienced family caregivers will confirm that taking breaks actually makes you a better caregiver in the long run.
Consider the stress management strategies described below. They are based on years of research with family members. They can help you become more emotionally resilient. And, even if only in small glimmers, these strategies can remind you that there are also rewarding and sometimes fun aspects to caring for a family member:
When caring for an ailing loved one, it’s natural to focus on issues related to their health. An unintended consequence, however, involves risks to your own well-being. For instance, family caregivers often forego doctor visits for their own checkups. They are much more likely to be depressed than are noncaregivers. They are also more likely to eat poorly and not get enough sleep. In addition, many family caregivers turn to overeating, alcohol or prescription drugs to get relief. This is understandable, but not good for anyone.
The major culprit is stress. Higher rates of physical, emotional, and mental health problems among family caregivers are most strongly associated with the stress of providing care. It’s not how much care you provide. The issue is how stressful the situation is for you. Research has found the more stressed you feel as a caregiver, the more likely you are to develop health problems of your own.
Stress, for instance, causes anxiety and depression. It actually suppresses the immune system and increases the likelihood of heart disease, diabetes, cancer, colds/flu, and other infections. Family members caring for a loved one with dementia (memory loss) seem to experience the most stress. Not surprisingly, they also tend to develop more health problems.
Stress-relief activities are the best remedy. To keep yourself healthy and able to care for your family member over the long haul, write yourself a prescription for at least one of the following:
Social time. Spend time with others simply for fun and relaxation. Make it a point NOT to talk about the person you care for.
Exercise. Work off your frustrations and reinvigorate yourself physically. Or unwind mindfully through yoga or tai chi.
Crafts and hobbies. Do something you love, whether it’s art, music, writing, gardening, cooking, painting, or some other creative pleasure.
Religious/spiritual practice. If spirituality is a part of your life, make time for prayer or meditation. Attend the services of your faith community.
A support group. Meet with others in situations like yours to laugh, cry, and share tips.
Respite. Take a break from caregiving. It’s not selfish, it’s essential!
Sleep is key to good health. As a society, we seem to think we can safely carve more hours out of the day by taking it from our sleep at night. Not so! People who are sleep deprived have greatly compromised immune systems. They also get in more car accidents and have higher rates of depression. Naps midday are okay. But they can also disrupt your normal sleep rhythms at night, leading to insomnia. Bottom line, sleep is not a luxury. It is crucial to good health!
See the doctor for regular checkups. Ignoring your own health issues will only put you and your loved one at risk. Make sure you keep up with regular screenings. And see the doctor if you feel depressed, fatigued, or not well. Too often, family members put their loved one’s illness before their own. Although your own health may not be as impaired as your family member’s, that does not mean you are invincible. If for no other reason, keep your regular checkups just to be sure you stay healthy enough to continue giving care. You need to preserve your health for your loved one’s sake, as well as for your own.
Which of these stress busters do you think you could try first?
It’s important to know how to kindly draw a line when you’re caring for an aging parent. There is always more to do. It’s difficult to know when you’ve done enough. Your ability to set limits for yourself is foundational to your ability to care for your loved one over the long haul. If you’re not clear about when to say “no,” you’re headed for exhaustion and burnout. And then where will your loved one be?
Setting limits can bring up many conflicting thoughts and feelings. The science of cognitive–behavioral therapy takes a very constructive approach. Its message is, “Don’t believe everything you think!” That means we often get caught up in thoughts and feelings that seem true. On deeper examination, however, they are biased by inaccurate assumptions.
Inaccurate assumptions about caring can get in the way of wise decisions. For instance, we may believe that we can show our love only in certain ways. Or that we must give everything we have. If we don’t, then we don’t love the person we care for. You will be doing yourself and your family member a favor if you take a second look at your beliefs and consider alternate perspectives.
Common misconceptions that can interfere with setting appropriate limits:
“Mom/Dad did so much for me growing up. It’s selfish to say ‘no.’”
Alternate perspective.Self-respect is an essential life skill, as is self-knowledge. You need to pace yourself so that you can continue to give care for weeks, months, maybe even years. Consider this perspective instead: “I need to budget my time and energy so my own batteries stay charged. I will be a better caregiver in the long term if I avoid situations that are not genuinely productive.”
“If I show Dad how much I really care, then he’ll show me his love.”
Alternate perspective.We can never predict another’s behavior. Caring with “strings attached” sets you up for disappointment or, even worse, resentment. Consider this perspective instead: “Dad’s actions are about him, not me. I accept that he may never show gratitude. I am helping because helping is a value that is important to me.”
“Mom is so sick. I need to do everything I can for her.”
Alternate perspective.There is much in life that we can’t control. Be careful that you don’t assume responsibility for what you really don’t have the power to cure. Consider this perspective instead: “What is the single most beneficial thing I could do right now to help Mom feel better?”
Identify behaviors that bother you. Perhaps it’s Mom calling several times a day while you are at work. Maybe it’s Dad asking you to come over every weekend to take him shopping (on top of the doctor appointments, bill paying, and filling his pillboxes that you keep up regularly).
Consider alternative arrangements. A discussion focused on solutions is most likely to create a positive outcome. Have some thoughts in mind before you talk. If Mom calls a lot, maybe you give her a notepad to write all her questions down during the day and then have an agreed-upon time when you can talk after work. Or perhaps ask her to text and you’ll respond by the evening, and to save phone calls only for emergencies. With Dad you might look at all the things you do for him and think about how to have others fill some of those roles, especially the ones you like least. Maybe it’s time to hire someone. Or perhaps you can ask a sibling or friend to take on a task.
Communicate your needs and clarify expectations. Share your situation in an upbeat manner, along with your proposal for a solution.
“I love talking with you Mom, but when I’m at work, I’m not able to give you the attention I’d like to. During the day, please text me and if I can respond at the time, I will. For sure I will by 7:00 at night. Let’s just save daytime phone calls for emergencies.”
Stay flexible. They may have a solution in mind that will accomplish the same thing you are hoping for. Make room for that if you can. Also look for ways to avoid an all-or-nothing response. Saying “no” today does not mean that you won’t say “yes” next week. It’s possible that this task at this time is not as important as keeping your own well from running dry.
“Gosh, Dad, I can’t go shopping with you this week. Let’s brainstorm on some other ways you might get to the store.”
Validate and be open to their feelings. Remind yourself that you are not responsible for their life being smooth. You do what you can, and sometimes life is difficult. You can’t erase the fact that getting older has its challenges. Let them know you understand this is hard, but reinforce the need for change.
“I know it’s hard to be without a car, Dad. Let’s make a list of some options. I only have so much time in a week. So, let’s figure out which are the most important things that only I can do, and then find ways to get those other tasks accomplished.”
Get ahead of your guilt. You may need to listen to their emotions about their situation. Difficult as it may be for you, they have a right to those feelings. Aging is tough. Just be clear that you are not the cause of their challenges, nor are you responsible for their emotions about them.
Here are some internal strategies to help you hold firm for your needs:
Let them have their feelings. Consider it a sign of respect to let them express their feelings without you having to run in and fix the situation as though they were a child. They are a grown-up. You care about their emotions and can comfort them, but you don’t need to fix it. Just be present and understanding.
Acknowledge to yourself all that you do for them. You juggle many responsibilities and still step up to the plate. Be clear in yourself how much you are giving. It’s okay to have limits. If you don’t attend to your needs, you won’t be able to keep giving.
Avoid comparing your need to theirs. That really doesn’t You each have needs. It’s as simple as that. Comparing needs becomes a standoff because no one can be empathic enough to measure the other’s degree of need.
Practice saying “no” nicely. When you have a response you feel confident about, it’s more likely you will use it when your relative asks for something you can’t do. You don’t have to justify yourself. (Too much detail and they might start problem solving to help you find the time!) A simple “I wish I could, but that doesn’t work for me at this time” is a good standby. Or if you would genuinely like to help, “I can’t do ‘X’ next Thursday, but I could do ‘Y’ the week after that.”
Remind yourself how you will feel if you don’t say “no.” Research shows that we often say “yes” to something because we don’t like the way we feel about ourselves when we say “no.” (It’s easier on Tuesday to forget about the stress you’ll feel when Saturday comes and you can’t do the things you need to do because you said yes to Dad’s shopping.) Family caregivers often feel that their needs don’t count. Not true! Remember the benefits of having set a boundary—for example, avoiding a cold like the one you got last month because you were stretched too thin.
Reach out for help. Are you struggling to set boundaries with a loved one? You are not alone! Consider reaching out for support. An Aging Life Care™ Manager specializes in issues of eldercare and can guide you toward solutions; for example, a therapist who is experienced in addressing family caregiver guilt, or a support group to gain insights from others in the same situation. Learning to set boundaries and reach out for help is a vital part of your caregiving journey.
Heed the wisdom of safety experts. Remember the instructions when an airplane is in trouble: If you are traveling with someone who needs help, you must first put on your own oxygen mask and then help the person you care for. Prioritizing your well-being isn’t selfish. It’s a strategic and necessary step. By taking care of yourself, you are better equipped to help those who depend on you.
What are all the ways you have given help so far? What tasks honestly feel like they would stretch you too much?
You may not be able to control the course of your parent’s condition or the family’s dynamics. But you can take the edge off by learning simple physical and mental strategies to help your body relax.
Emotional distress sets off a physical reaction. When we feel scared or angry, our heart rate and blood pressure increase. Our breathing speeds up. Our muscles become tense. When the stress is chronic, our “fight or flight” response may be engaged for days, weeks, or months. That’s hard on the body. Stress creates tension, which generates anxiety, which creates more stress. It’s a nasty downward spiral. Plus, chronic stress has been shown to contribute to high blood pressure, clogging of the arteries, depression, anxiety, and even addiction.
Relaxation interrupts the physical side of stress. It also clears the mind, which means less anxious thinking about any issue at hand. And you just feel better!
Following are proven relaxation techniques. The Harvard Medical School recommends experimenting to see which strategies appeal the most to you.
Deep breathing. Sit comfortably, feet on the floor. Inhale slowly through your nose, counting to five. Breathe deep into your belly and then chest. Exhale slowly through your mouth, counting to five. Repeat. You may want to concentrate on a word like “calm” or “peace.”
Progressive muscle relaxation. Lie down or sit comfortably. Starting with your toes, tense your muscles for five to ten seconds, then release and relax for ten to twenty seconds. Focus on the sensations you feel during the relaxation phase. You might even imagine tension flowing out of you with each release. Move up your body to the calves; tense and relax. Then up to the thighs; tense and relax. Continue up through your abdomen, your chest, your arms, your neck and shoulders, and your face.
Visualization. Find a quiet room where you can lie down or sit comfortably. Close your eyes and take a few deep breaths. Then imagine yourself at your favorite place of tranquility (beach, mountains, etc.). Bring in as many elements of the place as you can: What would you be seeing, smelling, hearing, touching? Savor the scene for as long as you wish. Open your eyes slowly and do some gentle stretches to ease yourself back “into” the room.
What calming place would you like to “visit” today?
Tai chi, yoga, and qigong. These Asian disciplines mix slow flowing movements with deep breathing. You can often find classes at senior or community centers. Or search online for videos.
Prayer or mindfulness meditation. Try sitting in a quiet room, both feet on the ground, with eyes closed. Focus on a word or phrase that has personal meaning to you. Or there may be prayers from your faith that you wish to repeat. Whenever you catch your mind wandering, gently release the intruding thought and go back to concentrating on your breath and your chosen word or phrase.
Everyone benefits from ten to twenty minutes a day of genuine relaxation. Surely you can give yourself (and ultimately your family member) that small but potent gift of relief.
Caring for a family member can be a lonely experience. The more advanced their limitations, the more homebound you may become. Even if you can get out and meet friends, it can be difficult for them to relate to what you are going through. You may feel isolated and lonely even though you are in the company of people you enjoy.
A support group is a collection of people who are all in the same boat: Family caregivers who come together to share experiences, practical tips, and knowledge of community resources. If the group is led by a professional, educational materials may be presented or presentations given by professionals in eldercare who discuss a particular aspect of caregiving.
Most of all, support groups have been documented to bring about improvements in family caregiver quality of life. They reduce anxiety and depression, as well as loneliness and isolation. It helps to be with people who truly understand. You can vent and no one will judge you. Everyone in the group has experienced the same kind of frustration and sadness, guilt and resentment that comes with being a family caregiver.
You can talk as much or as little as you want in a support group. There is a firm rule that whatever is said in the group remains in the group. This confidentiality is crucial so people can feel free to share what’s truly going on for them.
Some groups meet in person. Others by phone. Some do videoconferencing. Some groups are listserves (email-based), while others may take place on social media (for example, a private Facebook group).
Most groups are free, sponsored by a senior center, a nonprofit, or a local church or synagogue. Usually they have a knowledgeable facilitator who can answer questions, suggest community resources, or bring in speakers. A facilitator also helps ensure that everyone who wants to, gets a chance to express themselves, and that no one person dominates the group.
Try out several groups before deciding on one to attend regularly. Each will have its own personality or flavor. Some may focus more on sharing feelings and tips. Others may be more educational in nature, with a theme each week. If you go to one and it doesn’t seem like a good fit, don’t rule out support groups altogether. A different group, a different sponsoring organization, a different focus, even a different time of day will attract different people and create a different tone. It’s worth experimenting.
To find a support group, try starting with Google, which can lead you to online groups. The local hospital or senior center may know of local in-person groups. Try contacting the local chapter of the nonprofit that focuses on your loved one’s condition, such as the Alzheimer’s Association or the American Cancer Society. You can also work with an Aging Life Care™ Manager. They can point you to support groups based on your preferences.
Which type of support group holds the most appeal for you?
Do you want to feel more emotionally stable and positive as you care for your family member?
Studies show that religion and spirituality help family caregivers maintain a sense of purpose, which seems to also bring about a better experience of caregiving. They focus on gratitude for what works well and on cultivating meaning in relationships. Individuals who draw upon their religious or spiritual beliefs appear to feel less burdened and depressed. Those who stay involved with their church or spiritual community also exhibit greater well-being, perhaps due in part to the benefits of social support.
In today’s fast-paced world, it’s easy to get overwhelmed and fall out of touch with yourself or out of step with your spiritual practices. We forget the wonder and magnitude of life. We easily lose touch with the divine.
Take a moment for self-reflection. These questions may help you recall simple ways to nurture yourself spiritually:
How do you describe your beliefs about life?What gives your life meaning? When you are struggling with your family member’s needs, recalling these deeper beliefs can help you regain emotional balance.
What can you do to connect to your spirituality?One way might be to spend time in nature. In daily prayer or meditation. Reading spiritual books or essays. Saying grace at meals. Or regularly visiting a place of special significance.
What activities or people nourish you spiritually?Does singing with others bring you alive? Or would you prefer a weekly reading and discussion group? Perhaps an annual retreat or periodic talks with a member of the clergy? Writing in a journal? Reaching out to people who express or live their spiritual priorities in a way that you admire?
Do you feel drawn to a faith community?Give yourself the flexibility to participate when you can. If in-person gatherings are not an option, explore online options. You will have more to give to your family member if you take the time to fill your spiritual well.
How can your faith community help you find meaning in your caregiving?Are there other family caregivers in your congregation? You might meet together to support each other spiritually.
How might you draw upon your faith or spirituality to support you in your caregiving?
More than half (54 percent) of family caregivers of older adults are married. And while family caregiving is one of many passages in the life cycle of a marriage—new baby, moving, job changes, health issues—81 percent of caregivers report that caring for an elder tested their marriage in ways they never imagined.
Emotional stress, physical fatigue, reduced leisure time, financial draws, and loss of privacy are just a few of the domestic pressures noted in an online survey of family caregivers. But some couples in the survey also reported feeling a benefit: Caregiving prompted a new kind of teamwork that actually strengthened their relationship.
Maintaining a balance between caring for a relative and nurturing your life partnership can be a challenge. Short-term sacrifices are reasonable. But since the average American family will spend three or more years assisting an aging relative, it is essential to have a long-term strategy. Caring for a parent is not worth sacrificing a good marriage or your future.
Begin with yourself
Prioritize your health. In particular, be sure you are eating well, getting adequate sleep, and not relying on unhealthy habits. Of course, it’s reasonable to ask for support from your partner. But if all you bring to the relationship is the leftovers of your energy, you are doing both of you a disservice. Do what you can to keep your own health and vitality the best it can be, given the circumstances.
Set limits with your parent. If the person you care for has the capacity to understand, you may need to talk with them about your need to have some private time with your partner. For instance, ask them to curb the persistent phone calls that interrupt time with your spouse later in the evening. You might request that they not call after 9:00 pm. Or arrange with other relatives to be on call certain days or times so your spouse can rely on your undivided attention.
Get help with caregiving. If you can’t imagine having time when you are not available for your relative, and other family members can’t help, then it’s time to get paid assistance. This is especially true if the person you care for lives with you. You and your spouse need respite and some privacy. This may feel impossible, but your marriage deserves the effort and expense. Consult with an Aging Life Care™ Manager to find out about affordable options.
Make open communication a priority
Discuss fears, concerns, and expectations.You and your partner may have strong memories and assumptions based on watching your parents care for—or not care for—your grandparents. Explore how you each envision caring for the elders in your life. What’s the same? What’s different?
Listen without judgement. Focus on how you can support each other and be a team during this stage of your journey together. That starts with both of you honestly expressing your needs without fear of judgment. Try to express yourselves in terms of your individual needs rather than blame each other for ways those needs have not been met.
Stay constructive. You may each have to vent a little about frustrations, but then turn to problem solving as a team. “What can we do together to address this so both our needs get met?”
Review values and goals.Establish a sense of shared purpose. What is the meaning behind the care of an elder? Having a shared vision makes it easier to accept inconveniences.
Stay positive.Even when there are problems between you, notice and point out the good things. Express your gratitude for what’s going well. Compliment your partner on qualities or achievements you admire that are entirely separate from the caregiving portion of your lives.
Touch base frequently to see how things are going. Eldercare presents a changing landscape. As a result, needs and issues will also change within your relationship. Stay current with each other. If circumstances change, be open to renegotiating any agreements you’ve made so they fit the new situation.
Be responsive when your partner shows signs of stress. Warning signs of trouble might include drinking, withdrawal, angry outbursts, or staying out more. Share your concerns and kindly ask what they are feeling. Demonstrate that your spouse’s emotional and physical needs are a priority. Problem solve together.
Spend fun time together
Set aside time for your spouse.Whether it’s a walk, a movie, a weekend away, make sure to have fun together regularly and often.
Make it quality time.Pay attention to your spouse and be fully “present” for your time together.
Stay playful.Separate your fun time from time you spend solving problems. Create moments that are just about feeling happy together. No discussion of caregiving or finances on date night!
Express small gestures of love. Cooking a favorite meal, bringing flowers for no particular reason, or making a fuss over a birthday or your anniversary. These small efforts can go a long way toward affirming your caring and commitment to your partner.
With a regular loving connection, you and your partner can come through this stronger than ever.
If the strain is becoming too much
Seek the help of a therapist. Unmet needs due to caregiving could lead to divorce. You want to be sure that you are making conscious choices rather than reactions you might regret later.
Consider alternative caregiving arrangements. If your marriage is in jeopardy, be honest with other family members about your need for their help with caregiving. If there is no one to help, then explore other caregiving arrangements, such as adult day care, memory care, or assisted living. Talk to an Aging Life Care Manager to find out about options and the best providers in the area.
What can you do to enhance your domestic relationship? How can you nourish it so it can also serve as a source of support for you?
No matter how much you love your family, taking care of an aging relative can be stressful.
To offset the stress, consider the power of positive thinking. A University of North Carolina stress study has shown that people who “seed their lives” with moments of positive emotions are more resilient in the face of challenges. This approach doesn’t mean ignoring or denying the negatives. Instead, it means taking time to notice the “micromoments” of things that are going well.
So does this mean you should go to more movies or eat more chocolate? Not really. According to Dr. Martin Seligman, a University of Pennsylvania researcher and former president of the American Psychological Association, these sensory activities might feel good in the moment. Longer-lasting avenues to happiness, however, come from focusing your attention on activities that feel meaningful. There is certainly tons of purpose and meaning in the caregiving work that you do! It’s a matter of turning your attention to why you do it.
The good news is that a shift in attitude or attention costs nothing and generally does not add inches to your waistline!
Despite the hardships, family members frequently mention the following rewards in caregiving:
“I’m grateful to be able to give back.”
“I now feel much closer to my mother.”
“I’ve become more compassionate.”
“I’ve learned to appreciate the little joys and triumphs in each day.”
“I’m proud of the new skills I’ve learned. I had no idea I could do these things.”
“This has given me a chance to reexamine my priorities and be sure I’m living the life I want to lead.”
If you are looking for ways to feel stronger and less stressed, perhaps it’s time to think in terms of the rewards in what you are doing. By accentuating those activities that have meaning for you (“seeding” your caregiving with positives), you can find more enjoyment. Very likely the person you care for will also feel the benefit.
Certainly caregiving can be tough. But usually there are also some positives. How have you grown or benefited from your caregiving role?
There are some days when you’ve just had it as a family caregiver. Particularly if the source of your stress has to do with your relative. The cause of their sharp words, outbursts, or resistance may not be something that can be changed (for instance, due to advancing dementia). The best strategy then is to make changes in your own approach or responses. For instance:
Take a break. This might mean physically leaving the room and going for a walk. If that’s not possible, suggest you talk later. Or count to ten with deep slow breaths so your reaction can be a bit more thought out.
Distraction. There are times when the best way to interrupt a tense dynamic is to shift attention to something else. There’s no point in arguing. Especially in the case of dementia, you can often suggest another activity in another room. Changing the environment can help disengage the source of frustration.
Focus on purpose. For instance, for many people, providing care is how they give back to their relative for the care received in earlier years. Caregiving might be a tough job, but you do it with love to the best of your ability. This is what gives it meaning, even when it’s hard.
Don’t take it personally. In the case of dementia, for instance, it’s not your dad criticizing you as a daughter, even if his words sound like that. It’s his disease that’s doing the talking. Even if there’s no dementia, your relative may simply be frustrated at all that they can no longer do, and unfortunately, they are taking it out on the safest person—you. Try not to take it personally.
Be flexible when you can be. If they want to do something a certain way and if you have the option, go ahead and do it that way. Going with the flow can ease a lot of tension.
Humor. Interjecting a joke can often lighten the mood. Be sure the joke doesn’t put your relative in a bad light. Just add some whimsy if you see the chance.
Plan ahead to avoid triggers. If you know there are issues or situations that spark strain between you, do what you can to avoid them.
Ask your relative for help. Depending on their level of awareness, you may be able to interrupt the feeling of being criticized or of not doing enough by explaining that you could use some help. Maybe there are ways they can pitch in so you are working as a team.
Respond with love. If a situation is tense, sometimes you can interrupt it by giving them a hug and validating that this is hard for all of you. That you are all on the same team.
Repeat affirmations to yourself. Like a mantra, when things get hard, remind yourself about all that you are doing. That you are doing your best and that’s all that can be asked of you.
