Caregiver Strain: Unrelenting Love Vs. Self-Care

A graphic featuring a photo of a mom with her two children, one of whom is in a wheelchair, and the words "Caregiver Strain, a blog by Nurse Lori."

We have teamed up with Nurse Lori Roa to bring you a series of blogs for caregivers. As both a registered nurse and a mom, Lori has excellent insight and ideas on multiple topics that we hope will help Variety Families, and all parents, on their caregiving journey. Click here to read her second blog, "Advocating for Your Child."

“Put your own oxygen mask on first, then put on your child’s oxygen mask.”

We’ve all heard that line when preparing for takeoff during the cabin safety review. Take care of yourself so that you can care for others. That is the bottom line when it comes to caregiving.

When caregiver strain is mentioned in the medical and mental health community, we usually think about an older family member who can no longer care for themselves, but we can’t bring ourselves to put them in a nursing facility. We feel like it is our responsibility to care for them, to not let them down. It becomes our job and life purpose to make sure they are taken care of and happy. But do we not feel the same when it comes to our children?

In a 2015 study published in The Gerontologist, it was concluded that a middle-aged woman caring for a child or spouse is found to be more stressed than one caring for an older family member. Caring for a child or spouse was also found to be more detrimental to her mental health. When it is our child, we tend to see no other choice but to give them everything we have to offer – even if it takes every resource we have.

As parents, we reach a new level of unrelenting love, a love that, at times, overcomes every bit of logic we possess. We may hide in the bathroom to cry for five minutes, but we will look in the mirror and tell ourselves to get it together because we need to provide a stable and positive place for our family. In that five minutes, there is sadness and guilt because we think we cannot do it all on our own and that we have let our child down by feeling overwhelmed. Then, later, when we tell our spouses, siblings or friends that we think we’re losing our mind, they call this “strength.”

This is not ok. We need to rewrite the playbook on parenting in this respect. There is no argument that you have love for your children like no other, but we must learn how to ask for help, when to say no, and when to care for ourselves before we get to locking ourselves in the bathroom and staring ourselves down in the mirror for a pep talk.

When the oxygen masks drop in the airplane cabin, you are instructed to help yourself before you help your child. We are better able to help our children when we take care of ourselves.

Identifying Caregiver Strain

But, first, we must identify when we, or our loved ones, are experiencing strain. It is often difficult to see changes occurring in yourself and those around you daily, but there are several unique signs of caregiver strain and burnout to look for, including:

  • Increased tiredness and not wanting to do everyday activities, nor participate in things they usually enjoy
  • Not sleeping well or not being able to fall asleep
  • Increased irritability or resentment, feeling anxious or depressed
  • Neglecting one’s own health, worsening health issues
  • Neglecting personal responsibilities that are not related to caregiving
  • Feeling hopeless and robotic, as if nothing matters but your caregiving actions
  • Increased alcohol use, smoking or eating more

In the long term, all of these can lead to increased risk of a multitude of health problems, which then impede your ability to be there for your child.

Who and What Can Help?

When you identify the signs above, it is vital to get help as soon as possible. But who and what can help? Asking for and accepting help is often the biggest hurdle because, first, we must admit that we are not superheroes and we can’t “do it all.”

The simplest option is to enlist the help of other family members and close friends. Make a list of ways others can assist you, so that, when someone offers, you have some options. Could your mom come help you with your laundry? Maybe your friend who makes delicious food could whip up a couple of freezer meals and drop them on the porch, or your sister could snuggle your new baby while you shower or take a nap.

If possible, consider giving yourself one or two days a week (or, at least, every month) to re-set so that you can be the best you can on other days. Have someone you trust care for your children and then get a haircut, have a coffee, go for a run, see a friend – do something that does not benefit anyone but you and your mental health. This time could also be when you schedule an appointment with a counselor or psychiatrist. A counselor can be a good resource and a safe space to vocalize our negative thoughts and mental health demons without fear of judgement.

If you’ve exhausted the options and there are no family and friends to ask to take over, you can turn to home health or even trusted sitters, if funds are available. While you may require a nurse for some situations, you may just need a specifically trained individual who can take over for a few hours in other cases. Many home health agencies offer nurse's aides who may be available to take over one day a week for less than a registered nurse’s rates. Respite care one day a week may sound like a small amount of time, but it can make a huge difference in your mental state, which makes you better for your child.

Whether you receive assistance from friends and family or a paid helper, it can be difficult to trust that someone else could possibly love and care for your child the way you do. If that’s the case, there are ways you can work to build that trust, even if it is gradual. Ask them to come for training for a week. Install cameras in your home. Check in by text. If the child is able, ask them to communicate their experiences. Leave for two hours the first time and build up from there. The point is to let your mind free for a few hours, not spend the day worrying that you left. You will come back with a sense of your independent self, which allows you to care for others to your best ability.

And if you work outside the home, which, according to Mayo Clinic, 60% of caregivers do, this adds additional stress. But your employer may be able to help! Talk to the human resource department about their Family and Medical Leave Act coverage – in some cases, you may be able to take up to 12 weeks to care for family if your situation at home has only become temporarily harder to manage. In the meantime, take some of your load off by taking advantage of what our internet age has to offer. Get groceries delivered, order a housekeeper with a click, and use text autofill services for prescriptions.

When it comes to managing your personal time, prioritizing and goal setting can be key. And, sometimes, saying “no” is necessary. If you’ve stayed up all night with your son who just had a major surgery and your best friend wants to have dinner, you may need to prioritize your sleep and mental state. Big picture: rescheduling dinner will not hurt your friend or you, but going out when you’re exhausted will have a negative impact on both your mental health and your ability as a caregiver. Do not feel obligated to push yourself through physical and mental exhaustion for the sake of others’ approval. This also goes for things like hosting holidays, taking on extra responsibilities at work, and going to family reunions.

Finally, don’t underestimate the power of doing “nothing,” even just for a few minutes! Get comfy and think about the ways you can help yourself and your mental state. What can you do for yourself? Drink more water? Take a 15-minute walk or run every day? Eat a piece of fruit with breakfast and a vegetable at dinner? Journal before bed? Again, it doesn’t sound like much, but this little goal that is for you, and only for you, can make a world of difference between normal levels of stress and losing all sense of self.

We love these little humans with all of our very being. But we cannot lose ourselves because, then, our children also lose us. We must take care of ourselves, mentally and physically, so that we can give them the best we have to offer – we are no good to our child if we are exhausted, malnourished and our mind is in 100 different places. Don’t just cry in the bathroom and put on your “strong face,” find your balance to create real strength.

Put your oxygen mask on first.

- Lori Roa, RN