Few people are prepared for the responsibilities and tasks involved in caring for loved ones who are ill, elderly, or disabled. The success of the relationship between you and your loved one depends on several factors. One of the most important is how well you take care of yourself, empowering yourself to be there for the person you are caring for. Let's look first at what causes the stress in such a relationship, and then we will explore some ways to care for yourself as you care for another.

Sources of Stress

Caring for someone who is sick or disabled causes tremendous stress. This stress comes from several directions and each has a different effect on the caregiver. The following are the main sources of such stress:

1. Being far away: In most families, people are spread out across the country and are not always available to help with caring for a sick or elderly person. This places extra stress on the person nearby, who often must contribute the most in terms of time and money toward the patient's care. The out-of-towners may not realize how much time and money the person close at hand is devoting to the care of their family member.

2. Financial stress is inevitable when someone requires an excessive amount of care. For example:

a. Many caregivers spend their own money to cover expenses that are not covered by insurance or Medicare.

b. The family members who are less involved may not realize how expensive certain items are and may even resist helping to pay for them.

c. The primary caregiver may have to work fewer hours or find less demanding work (which may pay less money). Many caregivers have to stop working completely in order to care for the patient.

3. Cultural expectations: In some cultures, daughters are expected to care for parents, and in others it is not acceptable to place relatives in nursing homes.

4. Relationship stress: In addition to the financial stress, all of these factors create enormous stress on the relationships among family members. This can lead to an additional layer of problems if it is not openly discussed and resolved.

5. Physical stress: Caring for an ailing person can be a physical challenge. Activities like cooking, cleaning, doing laundry, and shopping can be exhausting, especially when they are added to the responsibilities of your own life.

6. Home alterations: If the patient continues to live at home, you may need to make alterations such as building ramps or railings. Everyone in the home will have to adjust.

7. Social stress: Providing personal care 24 hours a day can cut off the primary caregiver from family and friends. You may be too tired to have an evening out, or you may not have anyone else to take over. This can result in your feeling angry and resentful toward the person you are caring for.

8. Emotional stress: As a result of these stresses, it is not unusual to feel a range of emotions, including anger, resentment, anxiety, frustration, sadness, and guilt. These negative emotions may conflict with the love you feel for your family member and the satisfaction you feel from contributing to the quality of his or her life.

With all of these kinds of stress, it is not surprising that many caregivers become overwhelmed and begin to feel burned out.

Signs That a Caregiver Needs Help

How do you know if the stress is becoming too much for you? The following is a list of signs that you need help. Take a moment to look through these and identify those that are now problems for you or may be potential problems.

1. You don't get out much anymore.

2. You argue with the person you care for.

3. You have conflicts with other family members.

4. You abuse drugs, alcohol, or medications.

5. Your appetite has changed.

6. You isolate yourself from others.

7. You behave in a compulsive manner or are overly focused on minor details.

8. You feel listless; you lack energy.

9. You feel more angry, anxious, or worried than usual.

10. You have a difficult time controlling your emotions.

11. You have a hard time concentrating.

12. You have physical symptoms of anxiety, such as an upset stomach, headaches, or a racing heart.

13. You often forget things.

14. You are clumsy or accident-prone.

15. You have self-destructive or suicidal thoughts.

16. You sleep more or less than usual.

17. You never seem to get enough rest.

18. You feel guilty about your situation.

Caregiver Survival Tips

1. Find out about resources before you need them. For example, don't delay researching nursing homes until the patient needs to be placed in one.

2. Seek all the support you can find. Be on the lookout for groups, individuals, and organizations that provide emotional, social, physical, and financial support.

3. Ask your family and friends for help. They may be able to provide you with time, knowledge, or money.

4. Investigate adult day care facilities. They offer therapeutic, rehabilitative, and support services such as nursing, social work services, meals, or transportation.

5. Consider having meals delivered. Many organizations provide nutritional programs.

6. Consider hiring a home health aide. Aides can provide personal care at home such as help with eating, dressing, oral hygiene, bathing, administering medication, and light household tasks.

7. Find out about homemaker services. These services can assist with shopping, laundry, housecleaning, preparing meals, and taking clients to medical appointments.

8. Look into the offerings of hospital and surgical supply services. They rent or sell medical supplies and equipment like hospital beds, canes, walkers, bath chairs, oxygen, and other equipment.

9. Check out respite care services. They provide relief to caregivers.

10. Look into social day care. They provide recreational activities, social work services, hot meals, transportation, and some health services.

11. Find out about transportation services. They provide transportation to and from medical appointments or other care services.

12. Find out about skilled nursing services. They offer professional help with specific medical problems.

13. Maintain your interests. Keep balance in your life.

14. Be realistic about what you can accomplish. Recognize what you can and cannot do.

15. Maintain communication with your family and friends. When tensions and misunderstandings develop (and they will), address them quickly.

16. Take care of yourself. Eat well, exercise, rest, and take time off.

Garrett Coan is a professional therapist,coach and psychotherapist. His two Northern New Jersey office locations are accessible to individuals who reside in Bergen County, Essex County, Passaic County, Rockland County, and Manhattan. Garrett also offers online and telephone coaching and counseling services for those who live at a distance. He can be accessed through http://www.creativecounselors.com or at 201-303-4303.