I Dont Think We Are In Oz

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Understanding the signs and symptoms of caregiver stress and tools to start reducing stress.

Understanding the signs and symptoms of caregiver stress and tools to start reducing stress.

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  • Caregiver Wave – Workshop Exercise
  • "the ability to direct one's thinking in whatever direction one would intend“
  • 2001 Short Version was implemented. The outcomes showed not significant changes between the 22 questions and the revised 12 question interview

Transcript

  • 1. I don’t think we’re in OZ anymore Peggy Naugle, CIRS-A, BCII Area Agency on Aging of Central Texas (AAACT) a partner of the Central Texas Aging and Disability Resource Center (ADRC)
  • 2. Overview
    • Caregiver Stress
      • Identify the ten most common warning signs of caregiver stress
      • Identify the physical, emotional and psychological manifestations of stress related to caregiving
      • ZBI (Zarik Burden Interview)
      • So what if I don’t make my bed!
  • 3. Welcome to their world Introducing the Caregiver Wave
  • 4. Symptom Cycle ANGER DENIAL SLEEP DEPRIVATION HEALTH PROBLEMS IRRITABILITY ISOLATION LOSS OF CONCENTRATION EXHAUSTION ANXIETY DEPRESSION CDSMP – Stanford University
  • 5. Loss of Concentration "the ability to direct one's thinking in whatever direction one would intend“ STOP ATTENDING WORRY TIME ACTIVE LEARNING
  • 6. ANGER Modern psychologists view anger as a primary, natural, and mature emotion experienced by all humans at times, and as something that has functional value for survival. High Blood Pressure Increased Heart Rate Increased Adrenaline Relaxation Cognitive Restructuring Problem Solving Better Communication Humor Counseling
  • 7. Denial
    • “ Mom was always forgetful”
    • “ Grandpa does those things for attention”
    • “ Well, yes, mother still drives, she takes the side roads”
    • “ I think grandma is faking her pain”
    • “ Dad can walk he just wants me to wait on him”
    • “ She doesn’t need all those pills”
    Denial is a defense mechanism postulated by Sigmund Freud, in which a person is faced with a fact that is too uncomfortable to accept and rejects it instead, insisting that it is not true despite what may be overwhelming evidence.
  • 8. Difficulty Sleeping
    • Almost 74% of all Americans do not get enough sleep each night
    • Most will feel sleepy or groggy during the week
    • 51% of adults say they have problems sleeping at least a few nights each week
    • Almost 1/3rd have trouble sleeping every night
    • Half of all Americans can not get up without an alarm clock
    • Alarm clocks interrupt sleep cycle causing, lack of energy, feeling unrefreshed in the morning
    • Those with sleep problems are twice as likely to feel stressed and tired
    • Lack of sleep leads to…
    National Sleep Foundation 2002 survey
  • 9. Health Problems
    • Fatigue
    • Obesity
    • High Blood Pressure
    • Heart disease
    • Shortened lifespan
    • Suppressed immune systems
    • Depression
    • Recent studies implicate sleep deprivation in diabetes
    • Sleep problems are reaching epidemic proportions, estimated to be the #1 health related problem in America - CNN, May 1997.
    • We sleep on average 6.9 hours/day, almost an hour less than a few decades ago.
    National Sleep Foundation 2002 survey
  • 10. Irritability “ Why do you always fall asleep on the table?” “ You haven’t taken your pills yet!” “ Please, not today, can’t you hurry up!” That’s your second donut!! *Warning Sign #1 An excessive response to stimuli (something external that influences an activity)
  • 11. Social Withdrawal
    • Not returning calls
    • Stop going to church
    • “ Don’t want to burden anyone with my problems”
    • No longer interested in their favorite hobby/pastime
    • “ My kids all work, I can’t call them”
    • “ I don’t need anything”
  • 12. Constant Exhaustion
    • A feeling of extreme fatigue (even when you do get the chance to sleep, it isn't a restful sleep); Becoming more emotional, for example, you get angry more quickly and are less patient which increases the risk of abuse and you feel a deep sadness which may lead to depression;
    • ● arguing more with your spouse, your children, your siblings, even with your parent;
    • ● a change in your eating habits (eating all the time or not eating enough);
    • ● a haggard appearance;    
    • ● showing poor judgment;   
    • ● having trouble remembering things;
    • ● constantly feeling overloaded and stressed;
    • ● feeling in danger of "crashing," having a fear of breaking down and then not being able to care for your parent, or yourself.
    youragingparent.com
  • 13. Anxiety
    • Characteristics of anxiety include:
      • Feelings of fear, worry or apprehension, Additional symptoms, such as tension, restlessness, jitteriness, insomnia, fatigue, distractibility, shortness of breath, numbness or muscle tension, Long duration (generalized anxiety) or short, intense bouts (panic attacks)
    • Causes of anxiety can include:
      • Difficulty adjusting to the illness, Common fears about death, including isolation and separation, Poorly-controlled pain, Side effects of medication, Withdrawal from benzodiazepines or opioids, if these are decreased abruptly, Medical conditions, such as dehydration, electrolyte imbalance, or withdrawal from drugs such as nicotine or alcohol.
    netofcare.org
  • 14. Depression
    • de⋅pres⋅sion
    • 1. the act of depressing.
    • 2. the state of being depressed.
    • 3. a depressed or sunken place or part; an area lower than the surrounding surface.
    • 4. sadness; gloom; dejection.
    • 5. Psychiatry . a condition of general emotional dejection and withdrawal; sadness greater and more prolonged than that warranted by any objective reason.
    • dictionary.com
    • What causes depression?
    • Depression seems to be related to a chemical imbalance in the brain that makes it hard for the cells to communicate with one another. Depression also seems to be hereditary (to run in families).
    • Depression can be linked to stressful events in your life, such as the death of someone you love, a divorce or loss of you a job. Taking certain medicines, abusing drugs or alcohol or having other illnesses can also lead to depression . Depression isn't caused by personal weakness, laziness or lack of willpower.
    • righthealth.com
  • 15. Dangers of Caregiving
    • personal illness/stress
    • potential for abuse of person being cared for
    • burnout
    • suffering from grief/loss
    • depletion of income
    • feelings of isolation, loneliness
    • legal/ethical issues -- power of attorney, substitute decision making
  • 16. Mortality
    • Caregiving as a
    • Risk Factor for Mortality
    • “ The Caregiver Health Effects Study”
    • Richard Schulz, PhD; Scott R. Beach, PhD
  • 17. Facts
    • 4 year research (1993-1998)
    • First known research regarding caregiver and mortality
    • A total of 392 caregivers and 427 noncaregivers aged 66 to 96 years who were living with their spouses.
    • 63% mortality rate for spousal caregivers
  • 18. Summarize
    • Primary care physicians who care for community-residing older adults may be in the best position to identify caregivers at risk. Older married couples should be evaluated as a unit, both in terms of their health status as well as the caregiving demands that exist in the home environment. To the extent that caregiving demands are high, opportunities for restorative behaviors are limited, and the caregiver is physically compromised, an intervention that reduces caregiving demands such as the provision of respite services may be needed.
    • Under extreme circumstances, it may be appropriate to relieve a vulnerable older person from caregiving responsibilities permanently by finding an alternative caregiver or institutionalizing the care recipient. In general, it is essential that we develop treatment approaches for older marital dyads that focus on the needs of both individuals simultaneously.
    • For more information on this study, google:
    • The Caregiver Health Effects Study
  • 19. ZARIK BURDEN INTERVIEW (ZBI)
    • Professor Steven Zarit
    • One of the most widely used tests of caregiving burden
    • It is simple to use and score
    • If you receive a high score on the test, you may be at risk for the physical complications of caregiver stress
    • Original 22 questions
  • 20. What Glenda the Good Witch Recommends
    • Listen to the caregiver, really listen
    • Acknowledge their feelings
    • Share experiences but never force your ideas on how caregivers should be dealing with caregiver issues
    • As individuals, it is very important for each of us especially caregivers to make our own decisions
    • PERSON CENTERED THINKING
    • Leave educational information about caregiving, support groups, mental counseling, respite, etc with the caregiver
    • Everyone of us gets busy, but making one follow-up phone call can help start the process for the caregiver to understand the importance of reaching out
  • 21. 9 Ways to get to the Emerald City
    • 1. Raise your activity level to pump up your energy. If you're on the phone, stand up and pace. Walk to a coworker's office instead of sending an e-mail. Put more energy into your voice. Take a brisk 10-minute walk. 2. Take a walk outside . Research suggests that light stimulates brain chemicals that improve mood. For an extra boost, get your sunlight first thing in the morning. 3. Reach out . Send an e-mail to a friend you haven't seen in a while, or reach out to someone new. Having close bonds with other people is one of the most important keys to happiness. When you act in a friendly way, not only will others feel more friendly toward you, but you'll also strengthen your feelings of friendliness for other people.
  • 22. 9 Ways to get to the Emerald City
    • 4. Rid yourself of a nagging task . Deal with that insurance problem, purchase something you need, or make that long-postponed appointment with the dentist. Crossing an irksome chore off your to-do list will give you a rush of elation. 5. Create a more serene environment . Outer order contributes to inner peace, so spend some time organizing bills and tackling the piles in the kitchen. A large stack of little tasks can feel overwhelming, but often just a few minutes of work can make a sizable dent. Set the timer for 10 minutes and see what you can do. In that time, take a quick look around the house and see how to get organized using everyday items. 6. Do a good deed . Introduce two people by e-mail, take a minute to pass along useful information, or deliver some gratifying praise.
  • 23. 9 Ways to get to the Emerald City
    • 7. Save someone's life . Sign up to be an organ donor, and remember to tell your family about your decision. Do good, feel good, it really works! 8. Act happy . Fake it 'til you feel it. Research shows that even an artificially induced smile boosts your mood. And if you're smiling, other people will perceive you as being friendlier and more approachable. There's no need to walk around in a constant state of worry. After all, what’s the worst that can happen if you bounce a check or leave wet clothes in the dryer? 9. Learn something new . Think of a subject that you wish you knew more about and spend 15 minutes on the Internet reading about it, or go to a bookstore and buy a book about it. But be honest! Pick a topic that really interests you, not something you think you "should" or "need to" learn about.
  • 24. For One Day, So What!!!!!
    • If I didn’t make the bed today
    • If I left a couple of dishes in the sink
    • If I didn’t sweep today
    • If I am late for once
    • If the cat ate the goldfish
    • If I didn’t pick up the mail today
    • If I had a bad day, there’s always tomorrow
    • If I fixed a TV dinner instead of cooking
    • If we ate Pecan Pie with Ice Cream
    • If we wore our pajamas all day
  • 25.