Stress

Many carers experience stress. You may feel overwhelmed, exhausted, frustrated or angry, or guilty. You may feel like you lack choice over your caring responsibilities. Stress can come in many forms but feeling stressed for long periods of time is also called ‘chronic stress’. Stress can result in physical changes in the body which if prolonged can result in stress related illnesses. High demands, lack of support and being isolated due to the caring role can all contribute to chronic stress.

Use of a portable toilet (called a commode) can be useful. Alternatively you can ask at the pharmacy or your health service where you can buy large absorbent pads to assist if the person is unable to tell you when they need to go to the toilet. Playing the person’s favourite music and using gentle lighting can make it a nice environment for the person. Take the time to just sit with the person. Holding their hand can help you feel connected. An extra chair in the room for visitors would be valuable.

What to do about feeling stressed

If you are experiencing chronic stress then you should see if you can reduce the demands on yourself by asking others (friends, family and the health care team) to do more. If you are caring at home, try and organise a break from caring by organising some ‘respite’ (this is where the person you are caring for has a short stay in hospital or an aged care facility). Alternatively, you may want to consider moving the person you are caring for permanently to an aged care facility, hospital or hospice/palliative care unit. Also, try some self-management strategies such as:

• Make healthy changes to your lifestyle (improve your diet, increase your sleep, attempt some gentle daily exercise, and try and socialise with friend and family)
• Identify the signs of stress (physical tension, increased heartbeat, a short fuse) and monitor your own stress levels. Identify if there are any situations that increase your stress and try to minimise those situations. Take a break for 5 minutes when you feel like your stress levels are increasing. Try some deep breathing before you return to the situation.
• Accept things or situations that are out of your control. Try not to expend energy on things you cannot change. Focus on things that you do have control over and can change.
• Plan ahead. Seek information about what is likely to happen in the coming weeks and try and plan ahead to reduce the burden on yourself.

Anxiety

When you are caring for someone who is seriously ill, it makes sense that you would feel worried about them, panicky about all the things you need to do, and anxious about whether you would be able to cope if there was an emergency situation related to their illness. It is normal to feel some level of anxiety as a result of your situation. However, it is not helpful or healthy to be feeling high levels of anxiety for long periods of time. Anxiety is associated with lower quality of life, poor functioning, poor sleep and diet, and even poor physical health. The signs of anxiety can include physical symptoms such as panic attacks, hot and cold flushes, racing heart, tightening in the chest, rapid breathing, restlessness, and feeling tense, wound-up and edgy. Psychological symptoms of anxiety include excessive fear, worry, thinking the worst, and obsessive thinking. Behaviour changes such as avoiding people or situations can also be a sign of anxiety.

What to do about feeling anxious

Firstly it can be helpful to seek support from your GP or other health professional. In addition, you can try some simple self-management strategies such as:

• Slow you breathing and concentrate on your in and out breaths
• Make health changes to your lifestyle (improve your diet, increasing your sleep, attempt some gentle daily exercise, and try and socialise with friend and family)
• Try and focus on the present moment
• Try meditation or progressive muscle relation (relaxing each of your muscles groups by tensing it, holding for 3 seconds, and then letting it go)
• Write all your worries down in a journal

Depression

Many people feel sad when they are caring for someone at the end of their life. However, depression is a term for when these sad feelings are more intense and last longer than usual. Depression means that you are sad, miserable or down most of the time and are not feeling interested in things or experiencing pleasure the way you usually would. You may have even lost your appetite, may be sleeping more or less than usual, and may have withdrawn from friends and family. You may be experiencing lots of negative thoughts about yourself and your situation and may feel like things will never get better.

What to do about feeling depressed

Taking time for relaxation, planning activities that you enjoy, socialising with friends and family, and looking after your health are all helpful ways to manage depression.

However, it is important that you seek help if you are depressed. Talk to your GP or other health professional about proven effective treatments for depression including talking therapies and medication. If you are having thoughts of harming yourself or others, then call Lifeline on 13 11 14.

Grief

If you are caring for someone at the end of their life, then you are probably already experiencing grief. Grief is the natural response to loss. You may be grieving for the loss of the life you once had, or grieving for the loss of a shared future, or grieving for the loss of the person as they were before they were ill, or grieving in advance for the loss that you know is coming when the person you are caring for dies. Grief can be exhausting, both emotionally and physically. It can affect any aspect of your life and be expressed in many ways. Grief can leave you feeling sad, angry, anxious, shocked, regretful, relieved, overwhelmed, isolated, irritable or numb.

What to do about grief?

• Share your grief with others. Talk to friends and family
• Look after yourself physically (eat well, sleep, regular gentle exercise)
• Give yourself time and space to grieve
• Seek help though your GP, a grief counsellor, support group etc.