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    Edward T. Creagan, M.D.

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  • Stress blog

  • Feb. 25, 2009

    Caretaker stress: You need to take care of yourself too

    By Edward T. Creagan, M.D.

32 comments posted

Each of us at MayoClinic.com has been profoundly touched by the struggles of case managers, patients and families trying to navigate through the bewildering minefield of the healthcare delivery "system." We each know that this is a non-system with fragmented care; crushing bureaucracy; and poor communication between many healthcare providers. So what can we do for ourselves, our families and our patients?

Colleagues often ask me what has been the biggest change I've seen in my 32-year career. Without question, it is the disintegration of the American family and the isolation of many patients, especially the elderly. Decades ago, the patient was admitted to the hospital for an acute event, managed as well possible and then typically returned home to the support of family and community. Today, that simply does not happen.

The family support network is a thing of the past, as divorces, blended families, step-families and professional responsibilities take their toll. As a result, the elderly patient typically leaves the hospital for an empty house or a nursing home. Those who do well in this environment have an advocate — a friend, a confidant, a social worker or a member of the clergy who acts on the patient's behalf. But here comes the challenge.

If the advocate is worn down, frazzled and distracted, the patient rarely will do well. For myself I know that the times when I was the most frustrated — with the system or our technidigital world, for instance — are the times when I was sleep-deprived. As simple as it sounds, a good night's sleep empowers and energizes us to tame the demons threatening our wellbeing and that of our patients and families.

I am not proposing that a good night's sleep is the panacea for life's miseries. But from my own experience and that of friends and colleagues, I've learned that compromising on sleep can compromise our thought processes and our judgment. And it has a ripple effect on our patients. We caretakers simply must take care of ourselves, and a big part of that is making sure we are rested and rejuvenated for the work we do.

Am I completely off base? Or can others relate to the clarity and the peace that a good night's sleep can bring? What else helps you keep going? Please speak up. As some poet said, "No person is an island." We are here to learn from each other.

32 comments posted

blog index

  • March 3, 2009 6:41 p.m.

    YES! REST! My husband just had two heart attacks. I rest as much as I can. I have us both on a very good schedule for day and night. I have certainly told our friends and Family, and all of them do understand and respect our times to chat on the phone or to visit. Yes, it is a long road back for us both.We pray each day that God does not give us more than we can handle. :)

    - NDY

  • March 3, 2009 5:38 p.m.

    I care for my elderly mother with Alzheimer's, my husband with progressive MS and an adult daughter with multiple disabilities. Sleep is a number one priority for me. Without the necessary sleep I couldn't function. There are too many important decisions to be made on a regular basis. If I were sleep deprived it would have a very negative impact.

    - Cate

  • March 3, 2009 3:43 p.m.

    I took care of my husband for 9 yrs.after he suffered 2 strokes. Sleep is very impt.but sometimes very interrupted. I found joining a support group, which met once a month was very helpful. Listening to other caregivers really helped me. Sometimes their stories made me feel that I had an easier job then many others. I also felt that prayer helped me when I was really stressed. Sometimes just going outside in my yard & talking to the sky helped me, when, I thought I can't do this anymore. My dear husband is now at rest, but, I would do anything to be back in the role as his 'caregiver'.

    - mary

  • March 3, 2009 3:24 p.m.

    I work the night shift, going on 20 years. I try to be disciplined about keeping to a routine and I aim for 6 hours of uninterrupted sleep. I KNOW that 6 hours is a magnic number--with less than that, the cortisol/insulin/leptin chemicals play havoc with my mood and ability to function. I mean even my most basic ability to drive the car is negatively affected. Scary. It was when I had gone 10 days without a 6-hour block of sleep that I knew that I had to put my own mother with Alzheimer's into a nursing home. I said I would never put her in a nursing home--but without sleep, I just could not go on caring for her.

    - chris

  • March 3, 2009 3:03 p.m.

    My husband is 5 years post-stroke. It has been a long rocky road to come to what everyone calls a "new normal". He was always a night owl and I'm not. But now that he's home 24/7, he wants me to stay up with him and watch TV until 2am. I still do the bulk of the home repairs, work part-time and take care of the bills, taxes, errands,etc. so I NEED my sleep. And I need my time out of house and away from him. And him sleeping till 11am really cuts into the time I can work on the house. We've started hiring some stuff out because I'm just getting drained. Sleep is definitely very important but so in any type of self-care.

    - AJK

  • February 28, 2009 3:27 p.m.

    I agree with what was in your article,my wife is a care give for a couple in their 90's. But in addition to that my wife has ADD and ADHD, which compounds everything. I have tried being very supportive, loving and making sure that we turn off the tv and communicate every night, my says it is very helpful to do that. She has also been under the care of a psychiatrist for the last 10 years and takes various meds for that, what else can I do ?

    - tbstress.blogspot.com

  • February 26, 2009 10:34 a.m.

    I completely agree. I visit my mother who's been in a nursing home for several years with advanced Alzheimer's disease, three or four times a day. Luckily I live only four blocks from the nursing home. This way I can keep tabs on everything that's going on, and she sees a friendly face all during the day, just as if she were "home". I run three small businesses from my home office, so I've worked things out so that everything gets accomplished. One thing I know though is that sleep and a feeling of well-restedness makes all the difference in the world to being able to handle all my various duties daily and give my mother the smiles and caring that she deserves.

    - PEM

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