USC Health Now

Whether it’s simply taking off work to drive Mom to her doctor’s appointment or looking after a spouse with Alzheimer’s disease, more than 44 million Americans provide unpaid care to the elderly. Here, USC experts give tips to help cope and replenish resources.

by Bob Barnett

Few of us choose to become caregivers. Often it’s thrust on us after a medical emergency—Dad takes a fall and needs someone to stay with during his recovery. Or it creeps up on us—first we’re only dropping by to help a dear friend with the bills, then we don’t trust her driving, so we do her shopping.

“Caregiving is a relationship, a loving exchange,” points out Maria Aranda, Ph.D., associate professor at the USC School of Social Work, who also holds a joint appointment at the USC Davis School of Gerontology. “It becomes problematic when that exchange gets tipped.” Even in the best of circumstances, you can feel overburdened, frustrated and resentful. Or just plain spent.

“I liken it to a long race,” says Bob G. Knight, Ph.D., professor of gerontology and psychology at the USC Davis School of Gerontology. “If you try to go full bore you’re not going to make it. It’s not good for you or the person you’re caring for.”

Caregiving is a marathon, not a sprint, and there’s no clear finish line. But developing your own self-care list can help you go the distance. Here are 10 suggestions to get you started:

1. Don’t try to do everything yourself. Ask for help.

“Sit down with family members early on,” advises Knight. “Let others do what they can to help.” Aranda describes it as creating “a patchwork quilt,” mixing and matching different people and resources. Check out the Internet or call your local senior services or department on aging. Trade ideas and reach out at every opportunity.

2. The more organized you are the better.

For example, keep all pertinent information—phone numbers, health insurance, calendar, list of medications, durable power of attorney—in one place, such as a portable file-folder for both day-to-day occasions and emergencies. Make a back-up copy or scan the information into your computer for extra security.

3. Plan ahead for future needs.

“Look at all the major issues,” recommends Knight, “such as finances and health care, that are down the road, particularly in cases of dementia. Nobody likes to think about them so we put them off. Then a crisis hits and it’s too late.” Walk your loved one through their living will so you understand their wishes. Also, review it with their physician to ensure you’ll be better prepared if and when you have to make difficult decisions.

4. Make time for yourself.

Spend time with family and friends to recharge your batteries. Have a favorite hobby? Don’t neglect it. You will feel refreshed and you’ll be able to better care for your loved one. Reward yourself with dinner out or a round of golf. “’I don’t have time’ is exactly the wrong answer,” Knight emphasizes.

5. Recognize there’s no perfect way to be a caregiver.

“We often feel it’s never enough, that we should be doing more,” says Aranda. Don’t judge or place unrealistic expectations on yourself and try not to let unresolved personal issues get in the way, says Knight.

6. Review and re-evaluate your caregiving and your options on a regular basis.

Take a step back from time to time and reevaluate. If you’ve been looking in on someone for a number of months, talk it over with them. “Involve them in the decision-making,” advises Aranda. They may have concerns they’ve been afraid to voice. Be willing to make changes that may help both of you.

7. Know your individual signs of stress, depression and physical difficulty.

Sleeplessness. Lack of appetite. A short temper. “We have our own personal signs of stress,” says Knight. “Pay attention to them.” Aranda recommends seeking out “a family friend, a counselor, or spiritual advisor for advice or assistance.” She also recommends joining a support group to help with feelings of loneliness or isolation.

8. Don’t lose your sense of humor.

A shared laugh can relieve stress and tension. “It can help you keep your perspective, “says Knight. It can also relax the person you’re caring for. Suddenly both of you are looking at the situation with shared eyes. A smile is good for us all.

9. Give yourself credit for your accomplishments.

We may feel it’s our responsibility to make everything better. But wishful thinking can’t turn back the clock. “Focus on the positive,” Aranda emphasizes. Dad still lives in the family home, thanks to you, even if he needs assistance to move around it. Your spouse with diabetes enjoys a quality of life she couldn’t otherwise.

10. Know when it’s time to act – or let go.

Constantly lifting a bed-ridden relative can become too much for both of you. “A nursing home isn’t always a bad decision,” Knight points out. “It’s always better to plan for it before it’s a necessity.” Caregivers must recognize that relationships change over time and come to an end. “Always be clear about your own values and what the person would want,” adds Knight.