The first rule of caregiving: take care of yourself

November 18, 2015 | by Veronique de Turenne

Cancer patients face unique difficulties – no doubt about it. But so do their  caregivers, family members and friends.

They’re so busy tending to the physical, emotional and sometimes spiritual needs of their loved ones that they don’t have time to take care of themselves.  The result is often depression, exhaustion, stress, sometimes even physical injury. It’s not easy, after all, to lift another person and tend to their basic needs.   

That selflessness comes with a price for everyone.
“We like to use the analogy that flight attendants use on airplanes before you take off,” said Ellen Polamero, a licensed clinical social worker in the Couples Coping with Cancer Together program at City of Hope. “Put on your own oxygen mask first—you won’t be much help to the person next to you if you’ve already passed out.”

That wry delivery gets a welcomed laugh, Polamero said, but the message she is sharing is serious.

“Caregivers in general feel their job is to first take care of the patient, whose needs are paramount, and that their own needs are not as important,” she said. “But if they don’t care for themselves and, as a result, let their own health slide, whether physical or emotional, then they really won’t be able to provide care and support to their loved one the way they truly want to.”

1.    Learn how to say yes -- and when to say no.

Caregivers must be willing to accept help from others, Polamero said.

“If there was ever a time to accept help from someone, this is it,” she said. “Be prepared with a list of tasks that someone else can take on for you, like bring food on certain days, walk the dog, or bring a certain book or a movie.”

Other people can help by driving a patient to a doctor’s appointment or to a chemo infusion. Such tasks enable more people to show their love and concern for the patient.

“This allows other people feel connected to the patient, which is also important,” Polamero said. “If you’re the primary caregiver, think about sitting down for 15 minutes or so per week with the patient and see what tasks can be shared with others.”

When friends and family are unavailable, professionals can be hired to assist with things like delivering groceries, providing rides or even providing patient care for a few hours per day or per week. This can give caregivers a much needed break for rest and self-care.

2.    Be creative and be specific.

“Otherwise, you may end up with lots of casseroles and rotisserie chickens in your fridge all at the same time,” she said.

Equally valuable is knowing when to say no, Polamero said. Time and energy are precious, particularly in the midst of treatment. Caregivers should feel free to decline social engagements, requests for assistance, or other non-essentials.

“Be aware of what things will help refill your cup and the patient’s cup, and what things will drain it,” Polamero said. “Focus on those things that fill you both up.”

3.    Keep your original relationship alive.

Marriages or other longtime close connections deserve special treatment.

“We often talk to the patient and caregiver about how to maintain the preexisting relationship in the face of the illness, especially for couples,” Polamero said.

Simple things such as finding a way to have a date night—whether it’s going out to eat, taking a walk, or settling in at home for a movie—can help keep the original relationship alive.

“It’s important to explore how to still be husband and wife and not just caregiver and patient because it’s so easy for medical issues to take over,” she said. The advice also applies to the bond between friends, parent and child, or siblings.

“Think about what made this a personal relationship before it became a patient-caregiver relationship?” Polamero said. “Remember those things and do your best to find creative ways to keep them going despite all of the other changes in your lives.”

4.    Stay active.

Caregivers often let physical activity slide. They shouldn’t. Simple activities like going for a walk, riding a bike, visiting the gym, or going to a yoga class can alleviate stress, and rejuvenate the body. Creative expression is also important. Whether it’s pursuing a talent or a hobby or simply writing in a journal, caregivers should also look for activities that foster creative self-expression.

5.    Seek Support.

Caregivers can gain a lot—and learn a lot—by sharing their experience with others in the same boat.

“Getting advice from a veteran caregiver can also be extremely helpful,” Polamero said. “When you are taking care of yourself, you will best be able to take care of the patient.”
At City of Hope, caring for caregivers is woven into the overall treatment plan. Our caregivers guide includes an overview of what to expect when taking on this vital role, including a Caregivers Bill of Rights, a look at financial issues that may arise, resources beyond City of Hope, and specific advice about caring for oneself.



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