Caregiver Connections
Helpful tips for family caregivers

How to beat "cabin fever"

Feeling housebound is common among family caregivers, and is particularly so for partners caring for a loved one with an “unpredictable” disease. Some conditions, such as congestive heart failure, make planning difficult because the patient’s stamina can fluctuate dramatically. The inability to make plans and get out of the house can be especially hard for spouses who are used to doing things together.

Isolation frequently leads to depression in both patients and their partners. It has also been linked with worsening physical health among family caregivers. Unfortunately, spouses tend to feel guilty if they go out with friends or engage in pleasurable activities. But staying cooped up only puts their own health, and ability to care for their loved one, at risk.

There are many solutions to “cabin fever.” Help your loved one’s spouse:

• Reach out. Maintain relationships with friends and family, even if just by phone or email. Join an online support group to connect with others who understand.
• Create personal time. Set aside time each day for a pleasant activity, unrelated to caregiving.
• Stay active. Do something physical every day, even if it’s just a walk around the house or yard.
• Get out of the house. Take a real break. Do something carefree. There are 168 hours in a week. Taking one or two hours for personal time without responsibilities is not too much!
• Safeguard health. Encourage your loved one’s spouse to talk to a doctor if you think he or she may be depressed. Depressed caregivers have much greater health risks. If they hesitate, remind them they will not be able to help their partner if their own health goes south!

Making treatment decisions

If your loved one is seriously ill, he or she is probably needing to make decisions about which treatments to pursue. These are deeply personal choices. And they aren’t always easy.

The University of Ottawa has developed an interactive decision-making guide for evaluating options. It helps you compare the alternatives, apples with apples, by:

• Gathering information into one document. Note as much as you can about each treatment: What are the benefits/advantages? What are the risks/disadvantages? Are there any side effects? What will “success” look like? (“How good does it get?”) How likely is that outcome? Will your loved one still be able to do the things that give him or her purpose? If a cure is questionable, and treatments are difficult, you might want to include the option of not seeking treatment. Your loved one might prefer to stay comfortable and pain free, and spend his or her remaining time and limited energy on those activities that provide pleasure and meaning in life.
• Applying personal values. For each option, rate how important each benefit is: five stars for extremely important versus one star if it doesn’t matter much. Use this system for rating the disadvantages. Looking at the number of stars for each option is very helpful in making a decision.
• Assessing the support system. Serious treatment decisions are often made in consultation with others: the doctor, a spouse, other family members. The decision tool helps highlight the role others play in the process.
• Identifying the next steps. As you work with the tool, it will become clear what’s missing. Maybe you need more information. Perhaps your loved one wants to talk with others who have made the same choice.

If your loved one’s condition is life threatening, our article on quality of life may offer insights to help with difficult choices.

Staying calm: Proven relaxation techniques

Anxiety is no stranger when you are caring for someone who is seriously ill. Or, for that matter, when you ARE the person who is ill. Medical emergencies, financial worries, everyday care issues. They all cause stress.

And emotional distress sets off a physical reaction. When we feel scared or angry, our heart rate and blood pressure increase, and our breathing speeds up. When the stress is chronic, our “fight-or-flight” response may be engaged for days, weeks, or months. That’s hard on the body. And it’s a particular concern for families dealing with breathing problems. Shortness of breath can generate anxiety, which causes one to feel short of breath, etc. It’s a nasty downward spiral.

You and your loved one can take the edge off by learning to relax. Relaxation stops the stress reaction and even makes breathing easier. It also clears the mind, enabling less anxious thinking about any issue at hand.

Following are three basic relaxation techniques that take about 10 minutes each.

• Deep breathing. Sit comfortably, feet on the floor. Put one hand on your chest, the other just under your ribs. Breathe slowly through your nose, counting to five. Only the hand at your belly should rise. Exhale slowly, counting to five. Repeat.
• Muscle relaxation. Lie down or sit comfortably. Starting with your toes, tense and relax your muscles, moving up your body to calves, thighs, etc. Count to five while tensing and to 30 while relaxing. Notice the difference between tense and relaxed.
• Visualization. In a quiet place, lie down or sit comfortably. Imagine yourself at your favorite place of tranquility (beach, mountains, etc.). Bring in as many elements of the place as you can: what you would be seeing, smelling, hearing, touching.

Share these techniques with your loved one. It takes dedication and practice, but everyone benefits from better stress management.