Caregiving, self-care during, beyond the COVID-19 pandemic

The COVID-19 pandemic taught us that care for the caregiver is part of taking care of one another. As society emerges from the pandemic, caregivers can take a collective deep breath and begin to take advantage of the return of supportive services. During this time, it's necessary to take time for self-care and recharge, so you can continue to give.

As a caregiver, you and your loved one are going through this experience together.

Here are a few tips to use as you navigate this time during and beyond the COVID-19 pandemic:

Take time to plan

Taking time for planning during change can be an effective tool for reducing stress. If you are the primary caregiver, spend time reflecting on and planning for how caregiving affects your other roles.

For example:

• What supports are available to your nuclear family when you are occupied with caregiving, such as laundry, housecleaning or child care?
• What will your work schedule look like and how much time away will you need? Can you speak to your supervisor and human resources department about your new role and seek Family and Medical Leave Act benefits?
• What can you do to address the needs of your nuclear family as you attend to your loved one in need of care?
• What are the expectations of you as the primary caregiver for this loved one? This should include expectations from the loved one and other family members. These expectations could be discussed at a family meeting before you accept the role.
• Can other family members take shifts, and how will that look? Having this conversation as a family is ideal. Remember, you are all in this together. Effective communication can smooth the transition into a caregiver role and reduce everyone's stress.
• What is the anticipated timeline for caregiving, and what are the next steps in care for loved one? This could include moving in with a family member, an assisted living facility or nursing home, or bringing in home professional caregiving or nursing support.

Be mindful of your needs, emotions

Your intentions for becoming a caregiver are good, and it can be a rewarding experience. It can be a blessing to be a go-getter and responsible, loving family member who wants to do all you can for your loved one. Yet take time to regularly check in with yourself to make sure your needs are being met.

Writing down your list of needs is a good way to organize your thoughts and check off what is important for you. Are you making time for self-care, including time with your friends and interests or getting enough exercise or rest? Are you taking steps to avoid getting to a point of distress? Do you have support from other family members or friends in the care plan role? If family is not an option, what public and private support resources are available to give you time to recharge?

If you are the primary caregiver and don't have additional support, you may start noticing a few red flags that you are stressed, including:

• Always putting your wants or needs on the back burner
• Becoming impatient
• Having racing thoughts
• Becoming short-tempered or frustrated
• Feeling disorganized or overwhelmed
• Experiencing fatigue or low energy
• Feeling nervous or anxious
• Facing a sense of loneliness or isolation
• Weeping or crying frequently, and not associated with the grieving process
• Feeling anger or resentment for the loved one

Take time each day to reflect and focus intentionally on your feeling and emotions. It’s OK to feel. You are made to feel. That doesn't mean you are what you feel. Your feelings are signs that you need to pay attention to something important.

Do you feel supported? Are you easily irritable? Angry? Sad? Resentful? Frustrated? Tired? Impatient? Hungry? Feeling guilty? Does your body ache? Are you having frequent headaches? How is your appetite? What physical things are going on with your body? How are you feeling about being able to manage everything?

It is important to pay attention to how you are feeling emotionally and physically when managing stressors because they can be the first clues into what you need. Then you can take steps to process, manage and attend to the wants and needs behind the feeling.

Map it out

Once you are aware of how you are feeling and what you need, you can communicate those needs to other supports or your loved one. Reflect on your capacity. You can't provide care 24/7 and need to have some time for yourself.

If you started taking care of an aging parent last year, you have adjusted and transitioned into what that caregiving looks like for you and your parent. Now you communicate what is helpful, whether it is shifts with other family for weekends away, help with errands or opportunity to exercise for one hour each day.

Make a list of resources or your personal and professional network to find support. This could include siblings, family, friends, neighbors, your loved one's friends, or local aging and disability resource centers. Another option is hiring support services, such as a social worker or nurse, for in-home or transitional care. Remember, it is important to put in the effort to find solutions for your loved one and yourself so you can continue to give and take care.

Make the ask

It can be a heavy responsibility to carry most of the caregiver role, and no one should be alone in the experience. It can be difficult or uncomfortable to ask for help. You may feel the pull that it has to be you to provide the help and do what is right for your loved one.

You may worry that others will not remember specifics about medications, allergies or your loved one's preferences. You may assume that you already know the response or feel like you shouldn't have to ask as "they should just know and be helping." You may not want to be a bother, feel that this is your duty or view support as an unfair responsibility to place on others. These are negative assumptions, and they are not helpful.

Now is the time to set aside assumptions or family dynamics and simply make the ask. I often tell caregivers: "Let's test it. You ask or state what's needed and let them say yes or no." The answer might be yes, and what a relief that will be. If it's no, you still have narrowed the options based on fact ― not assumptions.

Be specific when you ask for help. Instead of asking, "Could you come over and sit with mom sometime" or "It would be nice to have help around here," rephrase the ask to be specific, such as: "Could you sit with mom for two hours on Saturday morning? I'll need to know by Wednesday" or "Can you mow dad's lawn on Sunday afternoon" or "Can you do the laundry on Friday while I pick up my daughter?"

You also can make a to-do list and place in a visible location for others. The point is to make the communication clear. Even if the answer isn't immediately "Yes, of course," it can be the starting point for planning to meet everyone's schedule.

Building trust and allowing others to take on roles is important, as well. As you share the responsibility and trust others, instead of staying in a fear or worry mindset, your mood will improve, and you will feel more supported and recharged.

Set boundaries

Sometimes you will need to set boundaries of acceptable behaviors or requests with the loved one you are caring for. It's not uncommon for them to develop a preference for your care over others or expect that you stay with them despite having other caregivers available.

Good boundary-setting is respectfully and clearly communicating your expectations, limits and needs. Think about your loved one's capabilities. Is the request appropriate? If not, have a conversation about what you will or will not do. State facts when discussing expectations, such as: "Mom, I need to be able to go over to my daughter's house and see the grandbaby. Janelle is going to be with you when I'm gone. You know I love you, but it is hard for me when you get mad at me when I take time to see others."

You should acknowledge choices and allow autonomy within their capabilities. For example, offering the choice between walking with the roller walker versus using a wheelchair to move from the bedroom to the front porch.

Boundary-setting is a type of self-care, as well. Some people think that good caregivers give whatever their loved one needs or wants. Yet many caregivers are so busy taking care of their loved ones that they neglect their own physical, emotional and mental needs. Setting boundaries so you can take time to exercise, eat well, get enough sleep or socialize with friends or loved ones helps you recharge.

Finally, boundary-setting helps when managing strong emotions. Stressful situations and strong emotions often go together. Emotions tell us that something is important. Notice and acknowledge how you are feeling, but remember that you don't need to become the emotion.

You can be empathetic and supportive to your loved one, and have your boundaries and values respected while not allowing your emotions to dictate how you react to stress. For example: "David, you said you would be with dad today. I am sorry, but I cannot leave work early to come to dad's house now. I have next Tuesday and Thursday scheduled off from work to be with dad, and I will use up part of that vacation time if I come now," or "Mom, I made arrangements for the church volunteers to clean your yard today. Please do not ask them to leave. I appreciate you would prefer that I do it, but they do this for free, and it will allow me to redirect my energies to the other tasks needing to be completed."

Seek professional help

Many caregivers can benefit from professional mental health counseling because of the stress and challenges of the role. Therapists can help you work through your experience and identify your stressors. For instance, if family dynamics are contributing to your stress, a therapist can help you develop scripts for talking with loved ones about the situation and possible solutions. They also can help you develop solution-focused action plans for managing other challenging circumstances with caregiving.

Be gentle with yourself and patient with this ever-evolving process. You may have never done this before, and it might be messy and need adjustments. It's appropriate to ask questions; involve others; plan and organize; ask for help from your family and friends; be mindful of and communicate your wants and needs; set appropriate boundaries, including with your loved one; and use any and all resources.

Many caregivers reflect on their time and assess if they did all they could for their loved ones. You are taking time to provide for your loved one's safety, emotional, physical, spiritual and psychological needs. If you did all you can by taking care of your loved one, taking care of yourself and using your available resources, you did. The best measure of caregiver success is if you did the best you could with what you had in that moment. Just remember you don't have to go it alone.

Sarah Cormell is a licensed clinical social worker in Psychiatry and Psychology in Menomonie, Wisconsin