Editor’s note: The Caregiving Chronicles blog has partnered with Century Health Systems to bring additional expert information and advice to the MetroWest caregivers we strive to serve at CaregivingMetroWest.org. Century Health Systems, the parent corporation of Distinguished Care Options and the Natick Visiting Nurse Association, has allowed Caregiving Chronicles to get some valuable insight from its staff for our ongoing series of Q&A sessions with caregiving experts.

In this entry, we discuss the need for caregivers to make sure they are caring for themselves as well as their loved ones, and offer some strategies and advice for how best to do that. Providing insight is Judith Boyko, MBA, MS, RN, who has served as the CEO of Century Health Systems since it was established in 2001.

Boyko holds a Bachelor of Science degree in Nursing from the University of Pittsburgh, a Master of Science in Public Health from the University of Massachusetts, Amherst and a Master of Business Administration from Clark University. She has been recognized by the Home & Health Care Association of Massachusetts as Manager of the Year in 1997 and received the Deborah Blumer Community Health Leader Award from the MetroWest Community Health Care Foundation in 2007. She can be reached at info@natickvna.org or 508-651-1786.

Caregiving MetroWest: Why is it so important for caregivers to make sure that they take care of themselves as well as the loved ones they’re caring for?

Boyko: Automobiles need gas and clean oil to run effectively, among other things. This analogy can be made to caregiving; if caregivers are running on empty – if they are exhausted, stressed, sick or otherwise running on empty – they will be of little use to the person in their charge.

Being responsible for the well-being of a loved one, whether it’s an infant or an elder, requires the caregiver to be healthy, alert and available – not easy when you’re ill or incapacitated.

In fact, according to Family Caregiver  Alliance, “women who spend nine or more hours a week caring for an ill or disabled spouse increase their risk of heart disease two-fold.” Additionally, “estimates show that between 40 to 70% of caregivers have clinically significant symptoms of depression, with approximately one quarter to one half of these caregivers meeting the diagnostic criteria for major depression.”

Caregivers are also known to suffer from lack of sleep, feelings of isolation and frustration and are at an increased risk of heart disease, which is the leading cause of death in both men and women, according to the Centers for Disease Control & Prevention (CDC).

CGMW: Why do many caregivers neglect their own needs and what are some strategies for the people who care about them to get them to care for themselves as well?
Boyko: The easy answer to why caregivers neglect their own needs is that they are looking after and caring for a loved one. That great responsibility, in caregivers’ minds, supersedes their need for self-care. And when caregivers don’t focus on their own health – not exercising, not eating well, not getting enough sleep – they get “burnt out.”

There are several ways for a caregiver’s family to ensure that their loved one is taking care of herself. For one, they can chip in and help. Respite is so important, especially when a caregiver may not be practicing self-care on their own. A friend or family member can step in for an hour or two so the caregiver can have some time to themselves.

Other ways a loved one can help a caregiver:
•    Take them out to lunch or to a movie
•    Make them an appointment for a massage
•    Offer to do their laundry; prepare meals for them; or go food shopping so they don’t have to at the end of a long day of caregiving
•    Encourage them to attend a caregiver support group – either in person or online
•    Talk to them. Give them the opportunity to communicate so they feel heard and have their feelings validated.

CGMW: What kinds of illnesses and other health problems do caregivers risk if they don’t take proper care of themselves?
Boyko: Without proper self-care, caregivers are at risk for a myriad of health issues: stress, anxiety or depression; a weakened immune system (which can lead to other issues); and higher risk for chronic diseases like “heart disease, cancer, diabetes or arthritis,” according to the Office on Women’s Health, U.S. Department of Health and Human Services.

Caregivers’ social lives also can suffer if stress levels and feelings of loneliness and isolation increase. Social withdrawal is also a sign of depression, so if you suspect that the caregiver in your life might be depressed, encourage her to seek support.

Other issues that may arise include:
•    cognitive decline
•    other mental health issues
•    lower levels of self-esteem

CGMW: What are some ways for caregivers to care for themselves physically? Diet? Exercise? Taking medications? Going to the doctor? Others?
Boyko: There are many ways for caregivers to take care of themselves and their bodies:
•    Exercising – it can help to relieve stress and benefit your overall health
•    Walking – it’s a great way to get exercise and clear your head
•    Eating well – proper nutrition is imperative to your energy levels and overall health; if necessary, speak with a nutritionist to find out what in your diet should stay – and what should go
•    Staying hydrated – Without proper hydration, your risk of headache, constipation, dizziness and more will increase. How much – and what – should you drink? Water, juice without added sugars and sports drinks are good options to consume throughout the day to keep your energy up and your body hydrated.
•    Minimizing stress – This can be accomplished through the activities mentioned above as well as by seeking counseling; practicing meditation and/or yoga; and discussing your situation with a physician, who can further recommend additional ways to reduce stress and maintain good health.
•    Asking for help – Whether it’s from other family members, close friends, neighbors or professionals, asking for and accepting help is critical. While many caregivers may feel that they are the only ones who know how to properly care for their loved one, accepting help can ease feelings of resentment, stress and isolation and can provide a caregiver the opportunity to care for themselves.

CGMW: What are some of the ways for caregivers to care for themselves emotionally to get the support and stress relief they need?
Boyko: Caregiver support groups are a wonderful forum for like-minded individuals in similar situations to share resources, tips and information. They are also helpful in relieving caregiver stress. Talking to a mental health professional or a caregiver specialist can be beneficial, too.

Listening to music can have a positive effect on someone seeking relief. Johns Hopkins Medicine says that “research has shown that listening to music can reduce anxiety, blood pressure, and pain as well as improve sleep quality, mood, mental alertness, and memory.”

Writing in a journal can also be helpful in self-care. Why? According to Psych Central, writing one’s thoughts and emotions can help to reduce stress; help the writer better resolve problems; and help to resolve disagreements with others.

Other ways to care for oneself emotionally include:
•    Learning to say “no”
•    Expressing gratitude
•    Practicing yoga and/or deep breathing techniques – this is a wonderful way to care for yourself physically, too
•    Reading, playing an instrument, painting or drawing – doing something you enjoy can help you to resist focusing on caregiving duties and give you a sense of satisfaction
•    Unplugging – don’t check social media, the news or anything that might cause additional stress or emotional drainage

CGMW: Beside the physical and emotional aspects of the caregivers’ self-care, are there other elements that caregivers should be aware of to make sure they are taking care of themselves?
Boyko: While there’s no “one size fits all” when it comes to self-care, there are some tried and true methods that work. Some of them include:
•    Scheduling “me” time
•    Playing – If there’s a child in your life, play with them. If you have a pet, play with them. Real Simple has a wonderful article on the benefits of play and how it can help to improve “health, happiness, and productivity.”
•    Just saying “no.” It’s hard to say no, sometimes, but the more you practice, the easier it will get. Friends and family will understand that as a caregiver, you might be feeling overwhelmed and that you just can’t commit to doing more.
•    Utilizing essential oils – they’re beneficial to our health in many ways. Health magazine suggests the following:
–    Smelling peppermint can make you more energetic.
–    If you’re having trouble sleeping, smelling some lavender oil can “increase(s) brain alpha waves associated with relaxation and deep sleep.”
–    Health reports that a 2013 study found that smelling a combination of lavender, chamomile and neroli can reduce anxiety and ease stress – perfect for a stressed-out caregiver.

CGMW: Are there any other thoughts or strategies you would like to share with caregivers to help make sure they are looking after their own needs as well as their loved ones’?
Boyko: While caregiving can undoubtedly be stressful, it can also extremely rewarding. Knowing that you’re doing your part to improve the life of someone you love can add to your own feelings of self-satisfaction and self-worth and add meaning to your life. But without taking care of yourself first and foremost, you won’t have the physical resources to do your job to the best of your ability.