Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver...

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Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR

Transcript of Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver...

Page 1: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR

Caregiving: Preventing Family

Caregiver Burnout

Vicki L. Schmall, Ph.D.

Gerontology Specialist

Aging Concerns

West Linn, OR

Page 2: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR

Focus of Presentation

The journey of caregiving for someone with physical disability and/or dementia

Factors that make the caregiving journey

particularly difficult

Strategies that can make for a healthier journey

Professional messages that make a difference!

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The Journey and Challenges

of Family Caregiving

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The Caregiving Journey

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Comparing the Journey

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Page 7: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR
Page 8: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR
Page 9: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR

The Caregiving Journey

Involves Change

Change in activities

Change in relationship with care receiver

Change in role and identity of caregiver

Page 10: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR

For the journey,

caregivers must take

care of themselves ...

And the reasons why...

Page 11: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR

Impact of Caregiving Journey:

Emotional

Increase in depression and anxiety. Associated with:

– Role overload – Poor health – Lower life satisfaction

before caregiving – Being an adult child

caregiver – Caring for someone with

dementia

Greater use of psychotropic drugs

Page 12: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR

Impact of Caregiving Journey:

Physical Health

Poorer self-rated health status

Aggravation of existing physical health problems

Decrease in immune function

Less likely to engage in preventive health behaviors

High level of psychological stress associated with negative health outcomes

Page 13: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR

Impact of Caregiving: Social

Decreased time for other family members

Decreased involvement in personal activities

Increased isolation

Page 14: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR

Factors Related to Higher

Stress in the Journey

Behavior and emotional problems in care receiver

Caregiver’s appraisal of situation as disruptive

Competing role responsibilities

Poor relationship prior to caregiving

Caregiving is not voluntary

Disagreements among family members

Living with care receiver

Page 15: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR

Dementia Caregiving Journey is

0ne of the Most Stressful

Page 16: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR
Page 17: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR
Page 18: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR

What makes for a Positive Difference in

the Caregiving Journey . . .

Having a sense of mastery and control

– Good information

– Skill building

— Sense of confidence

Page 19: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR

Dementia: A Dying Brain

Page 20: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR

What makes for a Positive Difference in

the Caregiving Journey . . .

Has a sense of mastery and control

– Good information

– Skill building

— Sense of confidence

Has social -emotional support

– Perceived vs. actual support

– Value of support group

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Page 22: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR

What makes a Positive Difference in

the Journey . . . (continued)

Uses a direct style of coping – Uses help-seeking strategies

– Uses problem solving

– Is able to reframe problems

Finds meaning/rewards in caregiving

Page 23: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR
Page 24: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR
Page 25: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR
Page 26: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR
Page 27: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR
Page 28: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR
Page 29: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR
Page 30: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR

What makes a Positive Difference in

the Journey . . . (continued)

Uses a direct style of coping – Uses help-seeking strategies

– Uses problem solving

– Is able to reframe problems

Finds meaning/rewards in caregiving

Takes breaks in care-giving – Prevent—not treat—exhaustion

– Discretionary—not obligatory—activities

Page 31: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR

Goal in Directing to

Services . . .

Target services effectively that address caregivers’ needs

Analogy to medicine

– The right diagnosis (identify the needs)

– The right medicine (correct service)

– The right dosage (sufficient quantity)

– At the right time

(when caregivers can & will use service)

Page 32: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR

Professional

MESSAGES that make

a difference!

Page 33: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR

Taking care of yourself is

the BEST GIFT you can

give to the person who

needs your care

Page 34: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR

“Trying to do it all” or

“Doing it alone” does

NOT make for a better

caregiver . . .

. . .And it makes the

journey more difficult!

Page 35: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR

One’s attitude makes it

easier or more difficult

to deal with the

challenges of caregiving

Page 36: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR

For a Healthy Caregiving Journey...

Avoid attitudes that block “balancing”

– Expecting perfection of self or others

– “No one can provide care as well as I can”

– “I could never…” “I would never…” “I should”

Page 37: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR

Attitude is . . .

The way you mentally look at things

Half empty? or half full?

Page 38: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR

For a Healthy Caregiving Journey...

Avoid attitudes that block “balancing”

– Expecting perfection of self or others

– “No one can provide care as well as I can”

– “I could never…” “I would never…” “I should”

Make decisions based on “what is best”

…for everyone

– NOT on promises or guilt

– NOT on pressures from others

Page 39: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR

Your emotions are messages

– Are you listening to the

message?

Page 40: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR

Let go of Guilt!

Examine rules and expectations

Forgive yourself

Examine the reality of promises

Recognize wishes are not deeds

Focus on what you’ve done well

Consult a professional

Page 41: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR

If caregivers are

experiencing feelings of

guilt ASK:

Did you actually do something wrong or hurtful?

OR

Do you wish you had done something differently?

Page 42: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR

For a Healthy Caregiving Journey...

Avoid attitudes that block “balancing” – Expecting perfection of self or others – “No one can provide care as well as I can” – “I could never…” “I would never…” “I should”

Make decisions based on “what is best” – NOT on promises or guilt – NOT on pressures from others

Pack light—Simplify and prioritize

Page 43: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR
Page 44: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR

For a Healthy Caregiving

Journey . . .

Accept what you cannot change

Let go

Do not “borrow trouble” from the future

Make plans for “the worst that could happen”; plan for the best

Page 45: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR

…Grant me the Serenity to

Accept the things

I cannot change,

Courage to change the things

I can, and the

Wisdom to know

the difference

Page 46: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR

Change(s) you can make?

Change the situation

Change my perception

Change my response

Page 47: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR

For a Healthy Journey . . .

Build support for caregiving – Find out what family can do

– Talk to supervisor and co-workers

– Plan for emergency and back-up care

Identify and utilize resources – Work place resources

– Community programs and services

– Eldercare Locator - 1-800/677-1116

– www.aoa.gov/elderpage/locator

– Geriatric care manager—www.caremanager.org

Page 48: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR

HELP

Asking for

is a

sign of

strength

Page 49: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR

Is there a hidden

“You” message

in your

“I” message?

Page 50: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR

Additional Professional Messages

Caregiving to adults is different than to

children

You have a right to set limits, to say “no”

Focus on what you’ve done well

Page 51: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR

When caregivers don’t take care of

themselves, they start “traveling down

the road” to compassion fatigue . . .

Compassion Fatigue

Caring

Emotional residue

Preoccupation

stress

Page 52: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR

Caregivers who suffer from compassion fatigue, experience a

frozen heart!

They no longer maintain compassion

Hearts become closed to the person they care for and to others

Frozen

Page 53: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR

Take care of your

“heart and spirit”

It’s �the “best gift” you can

give to your family member

who needs your care

Page 54: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR
Page 55: Caregiving: Preventing Family Caregiver Burnout I… · Caregiving: Preventing Family Caregiver Burnout Vicki L. Schmall, Ph.D. Gerontology Specialist Aging Concerns West Linn, OR