If you're providing care for a loved one with dementia, it's important to know that stress can threaten your health.
Some effects of stress are noticeable right away. We sweat, our head pounds, we might experience unpleasant digestive effects, and we have trouble falling asleep.
Once the stressful situation goes away, we'll probably go back to normal. But experts tell us that over time, stress damages almost every body system, from our heart and lungs to our brains. In March 2016, the American College of Cardiology reported that people with a greater amount of activity in the stress center of the brain, as shown by brain imaging, were more likely to later suffer a heart attack or stroke. According to study author Dr. Ahmed Tawakol of Massachusetts General Hospital, the negative effects of stress are "on par with smoking, high blood pressure, high cholesterol and diabetes."
Another recent study, this one from Albert Einstein College of Medicine, published in the journal Alzheimer's Disease & Associated Disorders, showed that stress puts us at higher risk of mild cognitive impairment (MCI)—a condition that is often a precursor to full-blown Alzheimer's disease. You've probably noticed that stress makes it hard to concentrate and remember things. The results of this study suggest that the effect can be cumulative and permanent.
A recent Caring Right at Home poll showed that almost 75 percent of our readers provide some level of care for loved ones who are living with health challenges. These caregivers are all too familiar with the worry, financial challenges and emotional distress that can go with the job. Maybe they also are dealing with their own health problems, perhaps holding down a full-time job, or dealing with the "Sandwich Generation" issues as described in the previous article. And when their loved one has Alzheimer's disease or other dementia, their stress level is likely to be even higher.
Recent studies highlight a particular irony: The stress from caring for a loved one with dementia raises the caregiver's own risk. For example, a much-publicized 2010 study from Johns Hopkins Medicine reported that husbands and wives who care for a spouse with dementia are six times more likely to develop dementia themselves!
Can Alzheimer's caregivers lower their stress level?
Experts tell us that stress results not only from the challenges we face, but also from the way we react to these challenges. So for Alzheimer's caregivers, it's a two-sided process: improving the situations that cause stress, and handling stress in a way that minimizes the impact on our health. Says Dr. Edwin S. Lowe of the Albert Einstein College research team, "Fortunately, perceived stress is a modifiable risk factor for cognitive impairment, making it a potential target for treatment."
1. Take a break. For most Alzheimer’s caregivers, this is the top way to reduce stress. Take time for yourself—for exercise, for your own healthcare, to laugh, to relax with activities that nurture your body, mind and spirit. Don't think of this as self-indulgent; think of it as a way to save your sanity and make you a better, more resilient caregiver.
2. Ask for help. Many caregivers will ruefully respond to suggestion No. 1 with, "Easy for you to say! How will I find the time? Who will care for my loved one?" Look into options. Ask if family and friends would stay with your loved one to provide you some downtime. National, state and local agencies offer support services for the increasing numbers of Americans with dementia. To find out what's available, begin with the Eldercare Locator (www.eldercare.gov) or your local Agency on Aging. Check out respite care offered by adult day care centers, or by assisted living or other residential facilities. Many people with dementia do best in their own homes, in familiar surroundings and minimized disruption, making in-home care a very good choice.
3. Select dementia-friendly support services. For your loved one, be sure that activities, events and services are appropriate for people with memory loss, meeting their social and emotional needs in a nonjudgmental setting. And for yourself, try a dementia caregiver support group, in person or online, to find an environment for laughter, tears, learning and sharing what you've learned with others who truly "get it." If your family decides to hire in-home care, be sure the caregiver is specifically trained in the needs of those with dementia. (You can find an overview of those services and expectations in the June 2016 issue of Caring Right at Home.) In-home care shouldn't merely consist of "parent sitting." While caregivers are out, the life of the person with dementia should be enriched with appropriate, meaningful activities and interactions.
4. Sign up for a caregiver class. Either in a classroom or online, dementia care training can increase your confidence and coach you on time-tested techniques to modify your care—and perhaps your home—to allow you to care for your loved one with less stress. Understanding the causes of your loved one's personality and behavior changes can help you anticipate problems and create innovative solutions. Contact the Alzheimer' Association, the National Institute on Aging or your local Agency on Aging to find a class in your area.
5. Try meditation or other relaxation techniques. Meditation, tai chi, mindfulness practices and yoga can help you lower stress through focus of attention, controlled breathing and an open attitude—letting thoughts and distractions come and go without judging them, helping you to clear your mind, release tension and even improve strength and flexibility. In May 2016, UCLA researchers even announced that yoga can delay memory problems in older adults, in part through creating resilience to stress.
6. Be kind to yourself. Are you your own harshest critic? Many caregivers report they never feel they're doing quite a good enough job. Remember—there is nothing you can do to restore your loved one to his or her former condition. Helping your loved one at this time is a labor of love and a great challenge. Be alert for that little inner voice that second guesses your caring, and take steps to silence that voice.
7. Talk to a counselor who is knowledgeable about caregiver issues. Serving as a caregiver offers many rewards—but it can be an emotional minefield, especially when you add in the changes to your loved one's personality resulting from dementia. ("I thought Dad had long ago forgiven me for wrecking the car in eleventh grade! But he keeps bringing it up.") A counselor can help you identify your specific stress triggers, cope with the mixed emotions of caregiving, and learn cognitive and behavioral tricks to consciously lower your stress.