Finding Balance for the Caregiver

Finding Balance for the Caregiver:
16 Stress Reducing Strategies By Lisa Bailey 

When my husband Phil’s colorectal cancer returned in October of 2006, this time in the liver and lungs, I found myself stressed to the max.  With my full-time job as a kindergarten teacher, my commitment to my adult children and grandchildren, and keeping tabs on my teenage daughter, adding compassionate caregiving to my life’s work demands from me an incredibly difficult balancing act. 

The following sixteen coping strategies have helped me in my attempts to live a balanced life.  Because caregiving is such a universal task, faced by nearly all of us at one time or another, I hope you find these strategies helpful as well.

1. Make all choices from a solid base of integrity. I try to make medical and personal choices from the base of my Christian faith, which helps free me from second-guessing myself.
2. Be clear about today’s reality. Don’t imagine things are worse than they are.  Enjoy the good parts of today and don’t let worries for tomorrow take over your emotions and thoughts.
3. Talk honestly to family and friends. Honest, frequent communication with close family and friends from the start of diagnosis is much easier than trying to play catch-up later. I discovered a wonderful, free Internet service at caringbridge.org  which has allowed me to create a Web site to communicate regularly about Phil’s health. 
4. Expect and prepare for tough talks.  Family and friends process the news about a serious illness at their own pace. They will not accept the reality of the illness on a schedule that meshes with yours. This means that sometimes family and friends will not understand the tension of your caregiving lifestyle, especially at first. This requires a difficult conversation about what the illness is, how it will be treated, and what kinds of side effects will be expected from the treatment and the disease itself. It is helpful to have a family conversation with the doctor present.This provides an opportunity for questions to be answered accurately.
5. Learn the medical lingo.  It will help you as a caregiver and a medical advocate to learn the lingo surrounding your loved one’s illness. The Internet is a helpful resource, but you need to learn what Web sites can be trusted and what Web sites have a hidden agenda. I have included a list of trusted Web sites I have used for medical information.  However, even with a trusted Web site, don’t believe everything you read. Not all information will pertain to your loved one’s situation and you can worry yourself into a frenzy over some Internet information you have read.  Ask questions of the doctors and nurses. Check the accuracy of your information if you are at all troubled or in doubt.
6. During treatment, pain or pain medication might do some talking.  Be aware that pain, stress and pain medications will release the patient from their social “filter” and they can and probably will say some interesting and difficult things at times.  Actually, caregivers do this, too, as stress lifts our social filters at unexpected times—forgive yourself as well when this happens. Listen and be compassionate as best you can. Children and teenagers will need help understanding the changes in their loved one’s personality, especially to know that the changes are not permanent. 
7. Control what you can control. Lots of articles about stress-management advise letting go of control; however, I have found that being in control of some areas of my life has greatly reduced my stress. 
   1. Get help with housework—paid or unpaid.  Help with household chores has helped to make our home a cleaner refuge for Phil as he recovers and a sanctuary for me. 
   2. Get help with yard work—paid or unpaid.  Our backyard is our vacation destination this year; we eat most meals on the deck, enjoy the variety of birds that visit our birdfeeders, play cards, do art work and garden.  Help with yard work makes this vacation destination possible.
   3.  Prepare meals in advance and freeze them.  I do bulk cooking and freeze pre-prepared meals
   4. Keep bills and insurance paperwork organized so there are fewer financial surprises. Make necessary phone calls to insurance companies, and pay bills, or call to arrange payments, on time.
   5. Plan your work; then work your plan.  Be efficient at your outside job and in taking care of home stuff.  Don’t let things pile up. 
   6.  Do three things every evening before you go to bed—laundry, dishes and take out the garbage. The morning will be much more of a gift.
8. Let go of what you cannot control. For me, this means “let go and let God.” I carry a scripture in my pocket from Jeremiah 29:11 which says, “For I know the plans I have for you,” declares the Lord, “plans to prosper you and not to harm you, plans to give you hope and a future.”  Cancer is what it is; I cannot change that, but I can and do trust God for our future.
9. Nest.  Everyone, especially people who are recovering from illness or injury and their caregiver, needs a comfy chair—a place to relax and rejuvenate. Make a comfortable nest for your loved one and for yourself by adding afghans, pillows, fresh flowers, candles, books and great music to your comfy chair area. This is important to do both at your home and at the hospital should there be an extended stay there. 
10. Make comfort food.  Think about what your patient is hungry for, and then consider the details—digestibility, comfort, correct textures, temperature and presentation.  A compassionate and informative book that I found helpful as I prepared food for Phil following chemotherapy and surgery is Laurel’s Kitchen Caring: Recipes for Everyday Home Caregiving, by Laurel Robertson, with Carol Lee Flinders and Brian Ruppenthal, R.D.  Laurel speaks with such love for both the patient and the caregiver and her encouraging voice revives my spirit for caregiving, especially in providing good nutrition for healing.
11. Enjoy life today.  During my husband’s chemotherapy treatments, our world becomes pretty small.  We find that watching television is an important diversion, and we have become fans of shows we probably never would have discovered without some enforced downtime. We also play cards and Monopoly, put puzzles together and rent many movies.  I found a new interest in sewing, knitting and watercolor painting.  Phil, a drummer, has never stopped his daily drumming practice or working at his business from home.  We try to enjoy simple pleasures everyday.  We remember that Phil is a person with interests, not just a cancer patient.  And I, too, am a person with interests; not just a cancer patient’s caregiver.
12. Journal for yourself.  There are so many ways to re-center yourself, but none works as well as journaling, in my opinion.  Even if you have never kept a journal, starting one now will help you clarify feelings, manage the stress and plan the work you need to do as caregiver. 
13. Keep a vision for the future.  None of us comes here to stay; we know that.  But we also know that we can “grow until we go,” and we should.  One scripture that came right to mind when Phil was first diagnosed with a recurrence of cancer was “Where there is no vision, the people perish.” Proverbs. 29:18 KJV. We make plans for our future.
14. Give.  While I have learned through Phil’s illness to receive the gifts of help, encouragement, prayer and love from other people, Phil and I continue to enjoy giving as part of our marriage. We enjoy praying for other people, talking to other patients in the waiting rooms, encouraging others as much as possible through conversations both in person, in email and through good, old-fashioned snail mail. Giving keeps us feeling emotionally and spiritually full and is always worth the effort.
15. Take good care of yourself.  Eat good food, exercise a little, rest well and learn to say no to outside demands.  See your doctor and dentist for checkups. Get away from the house now and then—even if it is just to the laundromat to do the bulky wash. 
16. Release yourself from expectations for perfection. As humans, we all experience finitude, our “feet of clay” when we do not have infinite energy, wisdom or capabilities to manage our lives. This is normal. Get through each day as best you can, and don’t dwell on mistakes.   

Today Phil is doing well, fighting the cancer with chemotherapy, prayer and a great sense of humor. I am blessed to be his partner in this fight. As long as I keep my balance, I feel I do a good job as a loving caregiver. I hope these strategies work to help you both in your caregiving work and in reducing the stress that comes from this part of life’s journey.

Lisa Bailey is the caregiver for her 55-year-old husband Phil, whose colorectal cancer has metastasized to his lungs.  They have been married for 31 years, and are parents to four adult children ages 18 to 34, and have eight grandchildren.  She is a kindergarten teacher who works full-time, as she provides the medical insurance for her family.