Stress Management Techniques for Caregivers Zanda Hilger, LPC Alzheimer s Association Spring Symposium March 29, 2017

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1 Stress Management Techniques for Caregivers Zanda Hilger, LPC Alzheimer s Association Spring Symposium March 29, 2017 Symptoms of Caregiver Burnout The symptoms of caregiver burnout are similar to the symptoms of stress and depression. They include: Withdrawal from friends and family Loss of interest in activities previously enjoyed Feeling blue, irritable, hopeless, and helpless Changes in appetite, weight, or both Changes in sleep patterns Getting sick more often Feelings of wanting to hurt yourself or the person for whom you are caring Emotional and physical exhaustion Excessive use of alcohol and/or sleep medications Irritability Compassion Fatigue Compassion fatigue is a type of stress caused by caring for others. Although burnout develops over time, compassion fatigue may come on suddenly. In his article Burnout and Compassion Fatigue: Watch for these Signs, psychotherapist Dennis Portnoy classifies compassion fatigue as a form of burnout. The symptoms of compassion fatigue can be worrisome and include: Less ability to function More stress than usual Caregiver feels traumatized Working harder, getting less done Irritability Feeling bored More sickness, aches, and pains Keys to Staying Healthy 1. Eat well 2. Make sleep a priority 3. Do something physical every day 4. Prevent back injury 5. Get routine and preventive health care 6. Practice a spiritual or mental life 7. Practice stress management techniques 1

2 Stress Management and Relief Techniques 1. Breathing Three deep breaths, several times a day, especially when feeling overstressed: Breath from the diaphragm up, trying not to move your chest. 2. Stretches CAUTION: only use these exercises as approved by a health care professional and to tolerance. Three deep breaths before and after the series of exercises below. Most people carry their stress in their neck, shoulders, and back. Repeat these exercises 3 or more times several times a day. Be prepared for the crackles in your joints. 1. Shrug shoulders under ears, relax. 2. Shrug shoulders under ears and roll them back. 3. Keeping your head level with the floor, rotate your head to the left and then slowly to the right as if you are trying to look over each shoulder. 4. Keeping your head level with the floor, tilt your head to the left and then slowly to the right as if your ear was trying to kiss your shoulder. 5. Tilt your head back not too far and just move it back and forth 6. Hold your arms out straight in front of you and squeeze your upper and lower arm muscles and make fists. 7. Hold both feet out in front of you and tense your leg muscles and relax 8. Holding your feet out in front of you, rotate your ankles first one way and then another. See the handout from this website KMMq1y2a4t8/TryFxxKbm2I/AAAAAAAAADk/oQHDMIOZ2D4/s1600/desk+stretches.jpg Mindfulness is the current buzzword and becoming increasingly popular. Dr. Jon Kabat- Zinn did the earliest work on mindfulness. His Mindfulness Based Stress Reduction (MBSR) program was started at the University of Massachusetts Medical Center in 1979; it is now offered as a complementary therapy in hundreds of health care organizations around the world. Mindfulness is widely researched and proven to have significant benefits but many of the techniques are centuries old. For example, meditation is a form of mindfulness and is often confused with it. Benefits: boosts immunity; reduces stress, anxiety and depression; improves memory and mental focus; reduces emotional reactivity; and deepens compassion and altruism. 2

3 Stress Management and Relief Techniques, 2 Definitions from Merriam Webster online Mindfulness 1. The quality or state of being mindful 2. The practice of maintaining a nonjudgmental state of heightened or complete awareness of one's thoughts, emotions, or experiences on a moment-to-moment basis; also: such a state of awareness Meditate 1. To engage in contemplation or reflection He meditated long and hard before announcing his decision. 2. To engage in mental exercise (as concentration on one's breathing or repetition of a mantra) for the purpose of reaching a heightened level of spiritual awareness 3. To focus one's thoughts on: reflect on or ponder over He was meditating his past achievements. Guided Imagery 1. Any of various techniques (as a series of verbal suggestions) used to guide another person or oneself in imagining sensations and especially in visualizing an image in the mind to bring about a desired physical response (as a reduction in stress, anxiety, or pain) 3. Basic mindfulness exercise 1. Go to a quiet space where you will not be interrupted. Turn off the radio, television, computer, beeper and phone. Settle into a comfortable chair or sofa. Place your feet on the ground or put your feet up, if you like. Close your eyes. 2. Take in a deep breath from way down in your belly; fill your lungs and slowly exhale. Slowly repeat this several times and feel yourself start to relax. Continue sitting quietly, breathing deeply, rhythmically, slowly. Clear your mind of all thoughts by focusing on inhaling and exhaling. Breathe in peace and calm. Breathe out tension and pain. 3. When your mind starts wandering and thinking of other things, as it certainly will, gently refocus on inhaling and exhaling. Maintain a passive attitude; don t judge or get upset about these thoughts. Simply notice them; picture them as balloons and let them float away. Refocus on breathing in peace and calm; breathing out tension and pain. 4. Start by spending three minutes a day on this deep breathing activity. Work up to twenty minutes. 5. When the time is up, gradually open your eyes and pay attention to the feeling of calm. 3

4 4. Five Senses Bring awareness to each of your 5 senses. The point here is to focus on the present moment and how each sense is being activated in that moment. The order in which you pay attention to each sense does not matter. 1. Hear: Begin to notice all of the sounds around you. Try not to judge the sounds- just notice them. They are not good or bad, they just are. Sounds might be internal, like breathing or digestion. Sounds might be close by or more distant like the sound of traffic. Are you now hearing more than you were before you started? You may begin to notice subtle sounds you did not hear before. Can you hear them now? 2. Smell: Now shift your attention to notice the smells of your environment. Maybe you smell food. You might become aware of the smell of trees or plants if you are outside. You might notice the smell of books or paper. Sometimes closing your eyes can help sharpen your attention. 3. See: Observe your surrounding and notice the colors, shapes and textures. If you really look, you may notice things that have gone unnoticed. 4. Taste: You can do this one even if you have food in your mouth. You may notice an aftertaste of a previous drink or meal. You can just notice your tongue in your mouth, your saliva, and your breath as you exhale. We have tastes in our mouth that often go unnoticed. You can run your tongue over your teeth and cheeks to help you become more aware. 5. Touch: Last one. Bring your attention to the sensations of skin contact with your chair, clothing, and feet on the floor. You can notice the pressure between your feet and the floor or your body and the chair. You can observe temperature like the warmth or coolness of your hands or feet. You might take time to feel the textures that you noticed by sight a moment ago. You can feel several objects on your desk to fully focus your attention on the present. 6. When finished, pause to notice how your body feels in this moment. Compare how you feel now with before you began. 5. Guided Imagery Your special place Pick a favorite place. It could be a garden, a waterfall, a room, or anything else. A place where you feel good and safe. Now, close your eyes and go to that favorite place. Walk around slowly and notice the colors and textures around you. What do you see?... What do you feel?... What do you hear?... What do you smell? Take your time while you walk around. Spend some time exploring each of your senses. And notice how good and relaxed you feel. Remember these sensations, they are the sensations of your very special place. A place where you can relax. Say to yourself: "I am relaxed, my body feels warm and heavy, I am safe here". Enjoy the feeling of deep relaxation. When you are ready, gently open your eyes and come back to the present moment. 4

5 Day at the beach Imagine - It is a beautiful sunny day...you are walking on a beach...the sky is blue...the water is crystal clear...you hear the sound of gentle waves lapping, as the light breeze caresses your skin...the white sand feels warm on your bare feet and between your toes...you are wearing flowing light clothes and breathing deeply, inhaling the smell of fresh ocean air...a sense of freedom washes over your body...you lie down and let your body sink into the warm soft sand...your are completely relaxed...you sink deeper and deeper into relaxation... When you are ready, gently open your eyes and come back to the present moment Refer to Handout Family Caregiver Stress Management Tips 7. Journaling 8. Adult coloring books, drawing, sketching 9. Crochet, knitting, sewing 10. Woodworking 11. Vision Boards 12. Online games card, board and video 13. Museums 14. Shopping 15. Manicures and pedicures 16. Foot and full body massages 17. Exercise - Tai Chi, Yoga classes, gym, or golf 18. Volunteer work 19. Other hobbies 20. Other ideas What do YOU already do? Or always wanted to do Resources: 1. Online searches type in some of the terms like stress management and see what you find 2. Calm.com free app or online 3. Work of Jon Kabit-Zinn, Dr. Andrew Weil, and others on health, wellness, and mindfulness blogs 6. Stress Busters for Family Caregivers James L West with funding from Area Agency on Aging Now what are you going to do with what we have talked about today? 5

6 Caregiver Stress Management Tips Go for a walk. Sign up for an exercise, yoga, or Tai Chi class. Do some deep breathing throughout the day. What three things are you grateful for? Write it down and put it somewhere you will see it every day. Add to it. Say no sometimes and don t explain why. Do nothing for a few minutes and not feel guilty. Go to bed early. Take a mental health day off from work. Keep a journal. Turn OFF the TV Find something good in EVERYone you meet. Make a list of your good traits. Have a good cry. Relax with a good book and/or soothing music Buy a relaxation tape at a used book store. Listen to a positive, motivational CD Go to YouTube.com online and listen to a symphony or your favorite music Rent a funny movie. Play your favorite music and dance to it by yourself. Write a special diary about your accomplishments. Work on your favorite puzzle. Work a crossword puzzle. Try Words with Friends or some other internet game on your computer, smartphone or electronic tablet. Browse in a book or record store as long as you want. Play the piano or other instrument. Take a warm bath. Take a sauna. Treat yourself to a manicure or pedicure Treat yourself to a massage or ask for it as a gift. De-clutter a room. Call a good friend or several. Watch the sunrise or the sunset. Go out to a restaurant by yourself. Take a scenic drive. Fix a special dinner just for yourself and eat by candlelight. Buy new clothes you can afford. Buy yourself a stuffed animal. Go to a pet store and play with the animals. Visit a zoo. Go window-shopping. Buy yourself something special that you can afford. Go see a good film or stage production. Write a letter to an old friend. Bake or cook something special. Go to a concert. Hug a child. Tell someone you appreciate them. Have breakfast in bed. Take a pottery class. Recycle your newspapers and cans. Donate blood. Look at clouds. Open a can of coffee. Listen to the rain. Make herbal tea. Sit by a fire and read. Take a nap. Fly a kite. Daydream. Doodle. Read a magazine. Bake bread. Tell someone you love him or her. Go into a hot tub or Jacuzzi. Go to a museum. Look out a window. Family Caregiver Education Program of Area Agencies on Aging and Aging and Disability Resource Centers

7 Neck and Back Stretches Caution: Do not attempt these stretches if you have neck or back problems or have been restricted by a physician from these and other activities. Modify these stretches to fit your needs and abilities. These exercises are provided to help relieve tension in your neck and upper back as part of an overall stress management plan.