Friday, February 5, 2010

Caregiver Burnout Series: Part Four: Supporting the Caregiver

Burnout and the "Giant Breast Syndrome:"

Every mother who has ever nursed a baby knows that to make breastfeeding work, you need two components:
  • Nourishment: food and fluid to make milk, and
  • Plenty of sucking to stimulate milk production!
Most mothers who are faced with Burnout understand the breastfeeding analogy immediately: we seem to get plenty of  "sucking," but few of us get enough nourishment. Translated further, we all have so many demands on us that we may feel we don't have enough nipples! What we lack is the kind of nourishment required to make more milk. And in this case, "nourishment" goes beyond food and fluids.
Another metaphor is to envision your life energy as fluid contained in a bucket -- but, a bucket with a hole in it! You have to keep filling your bucket, or it will soon be empty!

Enough metaphors? Let's get down to business and talk about what we need. You may find some of these tips discussed further as Caregiver Tips elsewhere in this blog.

1.    Move your body; exercise.
2.    Use the "HALT" acronym from AA.
          Don't get too HUNGRY, ANGRY, LONELY, or TIRED!
3.    Eat small meals regularly.
4.    Sleep.
5.    Take little breaks often.
6.    Seek humor!
7.    Listen to music that you like.
8.    Find "creature comforts," e.g. massage.
9.    Buy inexpensive treats that say "hang in!"
10.  Read or knit.
11.  Have a good cry.
12.  Steer clear of people who sap your energy.
13.  Avoid alcohol and other recreational drugs.
14.  Give back to the community somehow.
15.  Attend "Kidney Events."
16.  Learn any prayer that speaks to you.
       Examples:  the AA Serenity Prayer, and "The Four Agreements."
17.  Accept help from others.

A few more thoughts to consider:

In order to ask for help from others, you must know what you need!
I recommend an exercise I call the "Minimum Daily Requirements." What ARE your daily requirements for exercise,  food, touch, intellectual stimulation, etc.?  You are far more likely to get what you need if you know what it IS that you need.

Remember: It could be worse!
Every single day in my medical practice, I see examples of people whose lives are worse than ours -- much worse. In the early days of Steve's kidney failure, we used to say, "At least it's not the burn unit." It was our shorthand way of acknowledging that we have much to be thankful for.

Negative feelings about your partner are normal -- to a point!
Many Caregivers do have negative feelings about their partners from time to time. I know that there have been times when I didn't even LIKE Steve! Now, did that interfere with the quality of his Home Dialysis? No, but we had to agree not to bicker during treatments; it made him feel too vulnerable. Talk to a counselor if you find that negative feelings are beginning to dominate your thinking. You need a safety net; don't take your frustrations out on your partner with that fifteen guage needle!

The Caregiver role is critical to successful Home Dialysis. Yet, Caregivers need care, too. Often, we are so caught up in the seemingly more critical needs of our partner, that we don't get our own needs met. Unless, of course, we make a conscious effort to do so.

Caregivers, take good care of yourselves. You'll be more effective as a helper if there's something left for you.

Take care. Linda Gromko, MD

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